Therapeutic mammaplasty (TM) may be an alternative to mastectomy, but few well designed studies have evaluated the success of this approach or compared the short‐term outcomes of TM with mastectomy with or without immediate breast reconstruction (IBR). Data from the national iBRA‐2 and TeaM studies were combined to compare the safety and short‐term outcomes of TM and mastectomy with or without IBR.
A total of 2916 patients (TM 376; mastectomy 1532; mastectomy and IBR 1008) were included in the analysis. Patients undergoing TM were more likely to be obese and to have undergone bilateral surgery than those having IBR. However, patients undergoing mastectomy with or without IBR were more likely to experience complications than the TM group (TM: 79, 21·0 per cent; mastectomy: 570, 37·2 per cent; mastectomy and IBR: 359, 35·6 per cent; P < 0·001). Breast conservation was possible in 87·0 per cent of patients who had TM, and TM did not delay adjuvant treatment.
The authors conclude that TM may allow high‐risk patients who would not be candidates for IBR to avoid mastectomy safely. Further work is needed to explore the comparative patient‐reported and cosmetic outcomes of the different approaches, and to establish long‐term oncological safety.
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