71486 - Surgical complications after immediate implant-based breast reconstruction for breast cancer in women ≥ 65 years of age

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Abstract Introduction While immediate breast reconstruction (IBR) rates in breast cancer are increasing, they remain low in women ≥65 years. The aim was to investigate surgical outcomes in women ≥65 years receiving implant-based IBR. Method The population-based Stockholm Breast Reconstruction Database includes all adult women with breast cancer receiving an implant-based IBR in Stockholm, Sweden, 2005-2015. Primary outcomes within 30 days from IBR were 1) infection requiring antibiotics and 2) reoperation. Implant removal was a secondary outcome. Women aged ≥65 years were compared with younger age groups. Chi-square tests and multivariable logistic regression were applied for the primary outcomes, and Kaplan Meier analysis for the secondary outcome. Result Among 1749 cases of IBR, 140 (8.0%) were in women ≥65 years. Median follow-up was 74 months (1-198). Postoperative infection was not more common in women ≥65 years (22 out of 140, 15.7%) than in women <65 years (303 out of 1609, 18.8%; p=0.221). Reoperations were more frequent in women ≥65 years than in other age groups (≥65: 8.6%; 50-64: 6.5%; 40-49: 3.5%; <40: 1.6%; p<0.001), however, age ≥65 years was no independent risk factor in the multivariable analysis (OR 1.00, 95% CI 0.44-2.28). Overall 6-year probability of implant removal was 11.4%, (8.1% due to complications and 3.3% due to patient preference). There was no statistically significant difference between age groups for either reason (p=0.085 and p=0.794, respectively). Discussion Higher age alone was not associated with worse surgical outcomes after implant-based IBR in highly selected patients ≥65 years old when compared with their younger counterparts.

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