Læknablaðið - 15.09.2012, Side 23

RANNSÓKN
Heimildir
1. Jónasson J, Tryggvadóttir L. Krabbamein á íslandi
- Upplýsingar úr Krabbameinsskrá fyrir tímabilið 1957-
2006. Krabbameinsfélagið, Reykjavík 2008.
2. Brjóstakrabbamein, vefur Krabbameinsskrár. vvww.
krabbameinsskra.is - október 2011.
3. Autier P, Boniol M, LaVecchia C, Vatten L, Gavin A, Héry
C, et al. Disparities in breast cancer mortality trends
between 30 European countries: retrospective trend ana-
lysis of WHO mortality database. BMJ 2010; 341: c3620-
c3620.
4. Al-Ghazal SK, Fallowfield L, Blamey RW. Comparison of
psychological aspects and patient satisfaction following
breast conserving surgery, simple mastectomy and breast
reconstruction. Eur J Cancer 2000; 36:1938-43.
5. Elder EE, Brandberg Y, Björklund T, Rylander R, Lager-
gren J, Jurell G, et al. Quality of life and patient satis-
faction in breast cancer patients after immediate breast
reconstruction: a prospective study. Breast 2005; 14:201-8.
6. Rowland JH, Desmond KA, Meyerowitz BE, Belin TR,
Wyatt GE, Ganz PA. Role of breast reconstructive surgery
in physical and emotional outcomes among breast cancer
survivors. J Natl Cancer Inst 2000; 92:1422-9.
7. Cordeiro PG. Breast reconstruction after surgery for breast
cancer. N Engl J Med 2008; 359:1590-1601.
8. Woerdeman LAE, Hage JJ, Smeulders MJC, Rutgers EJT,
van der Horst CMAM. Skin-sparing mastectomy and
immediate breast reconstruction by use of implants: an
assessment of risk factors for complications and cancer
control in 120 patients. Plast Reconstr Surg 2006; 118: 321-
30; discussion 331-2.
9. Medina-Franco H, Vasconez LO, Fix RJ, Heslin MJ,
Beenken SW, Bland KI, et al. Factors associated with local
recurrence after skin-sparing mastectomy and immediate
breast reconstruction for invasive breast cancer. Ann Surg
2002; 235: 814-9.
10. Vandeweyer E, Hertens D, Nogaret JM, Deraemaecker
R. Immediate breast reconstruction with saline-filled
implants: no interference with the oncologic outcome?
Plast Reconstr Surg 2001; 107:1409-12.
11. Murphy RX Jr, Wahhab S, Rovito PF, Harper G,
Kimmel SR, Kleinman LC, et al. Impact of immediate
reconstruction on the local recurrence of breast cancer
after mastectomy. Ann Plast Surg 2003; 50: 333-8.
12. Al-Ghazal SK, Sully L, Fallowfield L, Blamey RW. The
psychological impact of immediate rather than delayed
breast reconstruction. Eur J Surg Oncol 2000; 26:17-9.
13. Jeevan R, Cromwell D, Browne J, Meulen J, Pereira J,
Caddy C, et al. Third Annual Report of the National
Mastectomy and Breast Reconstruction Audit. 2010. www.
ic.nhs.uk/mbr - október 2011.
14. Jeevan R, Cromwell D, Browne J, Meulen J, Pereira J,
Caddy C, et al. Second Annual Report of the National
Mastectomy and Breast Reconstruction Audit. 2009. www.
ic.nhs.uk/mbr - október 2011.
15. Chevray PM. Timing of breast reconstruction: immediate
versus delayed. Cancer J 2008; 14:223-9.
16. Goodwin SJ, McCarthy CM, Pusic AL, Bui D, Howard
M, Disa JJ, et al. Complications in smokers after
postmastectomy tissue expander/implant breast recon-
struction. Ann Plast Surg 2005; 55:16-9; discussion 19-20.
17. Behranwala KA, Dua RS, Ross GM, Ward A, A'hern R,
Gui GPH. The influence of radiotherapy on capsule
formation and aesthetic outcome after immediate breast
reconstruction using biodimensional anatomical expander
implants. J Plast Reconstr Aesthet Surg 2006; 59:1043-51.
18. Cordeiro PG, Pusic AL, Disa JJ, McCormick B, VanZee
K. Irradiation after immediate tissue expander/implant
breast reconstruction: outcomes, complications, aesthetic
results, and satisfaction among 156 patients. Plast
Reconstr Surg 2004; 113: 877-81.
19. Spear SL, Maxwell GP. Reconstruction and the radiated
breast: is there a role for implants? Plast Reconstr Surg
1995; 96:1116-8.
20. McKeown DJ, Hogg FJ, Brown IM, Walker MJ, Scott JR,
Weiler-Mithoff EM. The timing of autologous latissimus
dorsi breast reconstruction and effect of radiotherapy on
outcome. J Plast Reconstr Aesthet Surg 2009; 62:488-93.
21. Tran NV, Evans GR, Kroll SS, Baldwin BJ, Miller MJ,
Reece GP, et al. Postoperative adjuvant irradiation:
effects on transverse rectus abdominis muscle flap breast
reconstruction. Plast Reconstr Surg 2000; 106: 313-7.
22. Gill PS, Hunt JP, Guerra AB, Dellacroce FJ, Sullivan SK,
Ðoraski J, et al. A 10-year retrospective review of 758 DIEP
flaps for breast reconstruction. Plast Reconst Surg 2004;
113:1153-60.
23. Chatterjee JS, Lee A, Anderson W, Baker L, Stevenson
JH, Dewar JA, et al. Effect of postoperative radiotherapy
on autologous deep inferior epigastric perforator flap
volume after immediate breast reconstruction. Br J Surg
2009; 96:1135-40.
24. Carlson GW, Page AL, Peters K, Ashinoff R, Schaefer
T, Losken A. Effects of radiation therapy on pedicled
transverse rectus abdominis myocutaneous flap breast
reconstruction. Ann Plast Surg 2008; 60: 568-72.
25. Halyard MY, McCombs KE, Wong WW, Buchel EW, Pockaj
BA, Vora SA, et al. Acute and chronic results of adjuvant
radiotherapy after mastectomy and Transverse Rectus
Abdominis Myocutaneous (TRAM) flap reconstruction
for breast cancer. Am J Clin Oncol 2004; 27: 389-94.
26. Neyt MJ, Blondeel PN, Morrison CM, Albrecht JA.
Comparing the cost of delayed and immediate autologous
breast reconstruction in Belgium. Br J Plast Surg 2005; 58:
493-7.
ENGLISH SUMMARY
Results of Immediate Breast Reconstructions at Landspítali - The National University Hospital
of lceland, in 2008-2010
Jonsdottir K, Rafnsdottir SL, Kjartansdottir Th, Kristvinsson H, Jonsson Th, Asgeirsson KS
Introduction: In late 2007, the availability of immediate breast
reconstructions increased as a result of the establishment of an
oncoplastic breast surgical service at Landspítali - The National
University Hospital The aim of this study was to look at the rates and
early complications of immediate breast reconstructions in our hospital
in 2008-2010 and compare with the results from the UK National
Mastectomy and Breast Reconstruction Audit (NMBRA).
Material and methods: This is a retrospective population-based
study, including all women who had immediate breast reconstruction at
Landspítali in 2008-2010.
Results: 319 mastectomies and 157 breast reconstructions were
performed. Of these, 98 (62%) were immediate, (mean age 49, 29-69).
The immediate breast reconstruction rate was therefore 31%, with a
respective 55% for patients 50 years old or younger. In comparison, the
rate was 5% in 2000-2005. Immediate reconstructions with an extended
autologous latissimus dorsi flap were performed in 25 (26%) cases and
implant based reconstructions in the remaining (n=73, 74%). Inpatient
complications occurred in 12 (12%) patients and 5 needed reoperation
(3 post-operative bleeding, 1 skin necrosis, 1 imminent LD-flap failure).
Readmission due to complications after discharge occurred in 14
(14%), while 37 (38%) developed mild complications not requiring
readmission. The results were comparable to NMBRA, although the
rates of autologous flap reconstructions were significantly higher than in
this study (63% vs. 26%).
Conclusion: As a result of the establishment of an oncoplastic
breast surgical service at Landspítali, the rates of immediate breast
reconstruction have increased significantly (from 5% to 31%). The
complication rates are low and similarto NMBRA.
Key words; Breast surgery, breast cancer, immediate breast reconstruction, oncoplastic breast surgery, national mastectomy and breast reconstruction audit (NMBRA).
Correspondence: Kristján Skúli Ásgeirsson, kriskuli@landspitali.is
Department of Surgery, Landspitali - The National University Hospital of lceland.
LÆKNAblaðið 2012/98 463