David Smadja: Does Immediate Breast Reconstruction Increase the Risk of Thrombosis and Bleeding after a Mastectomy?
David Smadja, Professor of Hematology (PU-PH) at Paris Cité University, European Georges Pompidou Hospital, shared a post on LinkedIn:
“Breast cancer: does immediate breast reconstruction increase the risk of thrombosis and bleeding after a mastectomy?
This is the question we wanted to answer in our new study published in Blood Vessels, Thrombosis and HemostasisBlood Journals Portfolio
An important result: more complex surgery does not necessarily mean more complications!
Using the TriNetX multicenter database, we analyzed data from 11,538 breast cancer patients, divided into two comparable groups after propensity score matching:
Mastectomy alone
Mastectomy with immediate breast reconstruction by implant
The 90-day results are particularly interesting:
- 54% relative reduction in the observed risk of deep vein thrombosis (0.38% vs. 0.83%; p = 0.002).
- 33% relative reduction in the observed risk of postoperative hematoma (0.94% vs. 1.40%; p = 0.024).
- A trend towards a decrease in pulmonary embolisms, with no statistically significant difference.
These results do not demonstrate a protective effect of breast reconstruction.
Above all, they emphasize the importance of patient selection, their risk factors and perioperative management.
The essential message: the risk of thrombosis and bleeding does not depend solely on the complexity of the surgical procedure.
It should be evaluated individually for each patient.
This study helps to better document the safety of immediate breast reconstruction and to inform treatment decisions after breast cancer.
Delighted with this new scientific collaboration between Cedars-Sinai and Université Paris Cité PARCC – Paris Centre de Recherche Cardiovasculaire AP-HP, Assistance Publique – Hôpitaux de Paris Alexandre G. Lellouch M.D, PhD., H.D.R
Mokhtar et al. Thromboembolic and hemorrhagic risks after mastectomy with vs without direct-to-implant reconstruction.”
Title: Thromboembolic and hemorrhagic risks after mastectomy with vs without direct-to-implant reconstruction
Authors: Jonathan Mokhtar, John Y. Ha, Jewel Haddad, Curtis L. Cetrulo Jr, David M. Smadja, Alexandre G. Lellouch
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