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 similar to NMBRA.

Jonsdottir K, Rafnsdottir SL, Kjartansdottir Th, Kristvinsson H, Jonsson Th, Asgeirsson KS

Department of Surgery, Landspitali – The National University Hospital of Iceland.

Figure 1. Immediate and delayed total breast reconstructions in Landspítali 1999-2010.

Table I. Types of operations, operation time in minutes and length of stay in days. (*Sum of operation time in both operations).

Table II. Inpatient complications and readmissions because of complications, divided between types of reconstructions.

Table III. Comparison of outcomes between our study and The National Mastectomy and Breast Reconstruction Audit (NMBRA) with and without free-flaps ^{16,2111(pp18–38)}.  (*NMBRA average exluding free-flap).