Loss to follow-up after direct-to-implant breast reconstruction. Issue 1 (28th February 2023)

• Record Type: Journal Article
• Authors: Kim, Eun Key; Woo, Soo Hyun; Kim, Do Yeon; Choi, Eun Jeong; Min, Kyunghyun; Lee, Taik Jong; Eom, Jin Sup; Han, Hyun Ho
• Is Part Of: Journal of plastic surgery and hand surgery. Volume 57:Issue 1/6(2023)
• Page Start: 64
• Page End: 70
• Publication Date: 2023-02-28
• Subjects: Breast neoplasms -- postoperative complications -- loss to follow-up -- follow-up studies; Surgery -- Periodicals; Hand -- Surgery -- Periodicals; Orthopedics -- Periodicals; Surgery, Plastic -- Periodicals; 617.95
• DOI: 10.1080/2000656X.2021.1981350
• Languages: English
• ISSNs: 2000-656X

Abstract

Abstract: Loss to follow-up is inevitable in retrospective cohort studies, and patients are lost to follow-up after direct-to-implant reconstruction despite annual follow-up recommendation. We analyzed more than 500 patients to analyze the rate of loss to follow-up to plastic surgery and to investigate the factors affecting it. A retrospective review of patients who underwent direct-to-implant reconstruction between July 2008 and August 2016 was performed. Loss to follow-up to plastic surgery was defined as a difference of ≥ 24 months between the total and plastic surgery follow-up. The rate of loss to follow-up and associated factors including patients' demographics, surgery-related variables, oncological data, and early and late complications were analyzed. Of 631 patients who underwent direct-to-implant reconstruction, 551 patients continued visiting the hospital for breast cancer-related treatment. Of the 527 patients who were eligible for the study, 157 patients (29.8%) were lost to plastic surgery follow-up. Surgery-related variables, early complications, cancer stage, and adjuvant therapies were not significantly different. Younger age was significantly associated with loss to follow-up in univariate analysis. However, logistic regression revealed that a long total follow-up period, distant metastasis, and absence of late elective complications were significant factors contributing to follow-up loss. Late elective complications such as malposition, capsular contracture, and mastectomy flap thinning were more common in the follow-up group (48%) than in the loss to follow-up group (22%). Follow-up loss after direct-to-implant reconstruction was not associated with specific demographic or surgery-related variables, and postoperative courses significantly affected the loss to follow-up.