The official medical journal of the American Society of Plastic Surgeons reported that older women don't have an increased overall risk of complications from breast reconstruction after mastectomy. However, they are at increased risk of blood clot-related complications after tissue-based breast reconstruction.
Mark Sisco, MD, of NorthShore University Health System and University of Chicago and colleagues concluded the study that, "Older patients should be counselled that their age does not confer an increased risk of complications after implant-based post-mastectomy breast reconstruction."
The researchers identified nearly 41,100 women who had unilateral mastectomy (removal of one breast) between 2005 and 2012 using a national surgery database. About 11,800 patients underwent breast reconstruction. Compared to 39.5 percent of younger women, only 10.8 percent women aged 65 or older were less likely to have breast reconstruction.
The overall risk of complications did not differ significantly between age groups, after adjustment for other factors. The risk remained the same for older and younger women undergoing breast reconstruction using implants. The complication rate after breast reconstruction was 6.8 percent for older women and 5.2 percent for younger women.
Venous thromboembolism (VTE) the risk of blood clot-related complications after autologous reconstruction, creation of a new breast using the patient's own tissues called was significantly higher for older women.
VTE is a common and serious condition in which blood clots form in the leg or other veins (deep vein thrombosis) or lung (pulmonary embolism). VTE risk was nearly four times higher in women aged 65 or older, and more than six times higher for those aged 70 to 75.
"Breast reconstruction is an important option for women undergoing mastectomy and may improve patient self-esteem, body image, and quality of life," the researchers write.
According to Dr. Sisco and colleagues, "As such, it is impossible for older women to make informed decisions about the risks and benefits of post-mastectomy breast reconstruction that take into account their age."
The new study shows a similar overall complication rate for older versus younger women undergoing breast reconstruction. "Older women considering implant-based reconstruction should be assured that their age is not a factor in determining the risk of complications. However, they should be counseled that their age may confer an increased risk of VTE," Dr. Sisco and co-authors added.