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J Reconstr Microsurg 2016; 32(02): 147-152
DOI: 10.1055/s-0035-1563702
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

A 35-Year Evolution of Free Flap-Based Breast Reconstruction at a Large Urban Academic Center

Rohini Kadle
1   New York University Langone Medical Center, Institute of Reconstructive Plastic Surgery, New York, New York
,
Joshua Cohen
1   New York University Langone Medical Center, Institute of Reconstructive Plastic Surgery, New York, New York
,
William Hambley
1   New York University Langone Medical Center, Institute of Reconstructive Plastic Surgery, New York, New York
,
Alejandro Gomez-Viso
1   New York University Langone Medical Center, Institute of Reconstructive Plastic Surgery, New York, New York
,
William Rifkin
1   New York University Langone Medical Center, Institute of Reconstructive Plastic Surgery, New York, New York
,
Robert Allen
1   New York University Langone Medical Center, Institute of Reconstructive Plastic Surgery, New York, New York
,
Nolan Karp
1   New York University Langone Medical Center, Institute of Reconstructive Plastic Surgery, New York, New York
,
Pierre Saadeh
1   New York University Langone Medical Center, Institute of Reconstructive Plastic Surgery, New York, New York
,
Daniel Ceradini
1   New York University Langone Medical Center, Institute of Reconstructive Plastic Surgery, New York, New York
,
Jamie Levine
1   New York University Langone Medical Center, Institute of Reconstructive Plastic Surgery, New York, New York
,
Tomer Avraham
2   Department of Surgery, Division of Plastic and Reconstructive Surgery, Mount Sinai Health System and Icahn School of Medicine, New York, New York
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Publikationsverlauf

23. April 2015

09. Juli 2015

Publikationsdatum:
18. September 2015 (online)

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Erratum zu diesem Artikel:

Erratum to: A 35-Year Evolution of Free Flap-Based Breast Reconstruction at a Large Urban Academic CenterJ Reconstr Microsurg 2016; 32(02): e1-e1
DOI: 10.1055/s-0038-1632385

Abstract

Background This study aims to characterize the evolution and trends in free flap breast reconstruction at our institution.

Methods The authors reviewed and analyzed a registry of free flap breast reconstructions performed at a large urban academic center.

Results Between 1979 and mid-2014, a total of 920 patients underwent breast reconstruction with 1,254 flaps. The mean age was 47.7 years (range, 16–79 years). Over the past 10 years, patients were older than all patients seen in the prior decade (average age 48.9 vs. 46.1 years, p = 0.002). Overall, 82% of flaps were performed at our university hospital, 17% at a major urban county hospital, and < 1% at other sites. A total of 99% patients received postmastectomy reconstruction for an existing cancer diagnosis or prophylaxis. There has been a significant increase in reconstructions, with 579 flaps performed over the past 5 years alone. There has been a fundamental shift in the predominant flap of choice over time. Perforator flaps have increased in popularity at our institution, with 74% of all reconstructions over this past 5 years being perforator based. Perforator flaps were more likely to be chosen over nonperforator flaps in older versus younger patients (p = 0.0008). There has been a steady increase in bilateral reconstructions since the first one was performed in 1987 (p = 0.002).

Conclusions Over the past 35 years, our institution has seen a significant evolution in free flap-based breast reconstruction. Besides a massive increase in flap numbers we have seen a significant trend toward bilateral reconstructions and perforator-based flaps.

Keywords

breast reconstruction - free flap - microsurgery - trends - perforator flap