Risk Factors to Consider Before Breast Reconstruction Surgery

Anemia and anticoagulant use were both associated with higher blood loss and drainage volume, which may prolong a hospital stay after breast reconstruction surgery, according to recent study results.

Anemia and the use of anticoagulants (commonly known as blood thinners) may lead to complications that may lengthen hospital stays after breast reconstruction surgery, according to recent findings published in the Journal of Clinical Medicine.

Researchers from the Karl Landsteiner Private University of Health Sciences in Krems an der Donau, Austria, analyzed the results of 257 breast reconstruction surgeries in 195 patients receiving treatment for breast cancer. They were looking for factors that impacted the volume of postoperative blood loss as well as drainage fluid volume, which may be associated with longer hospital stays and therefore delay subsequent cancer treatments.

Study author Konstantin Bergmeister noted that the researchers were shocked to find that common cancer-related risk factors, such as body mass index, age and smoking status did not have as major an impact on blood loss and fluid output as anemia (low levels of healthy red blood cells) and anticoagulant use.

“Several studies have investigated perioperative risk factors for breast reconstruction, but the results are heterogeneous (differing from study to study). For us, it was surprising how pronounced the effect of anemia was in our study. It illustrates a clear risk factor that we can address before surgery,” Bergmeister, an associate professor in the Department of Plastic-, Aesthetic-, and Reconstructive Surgery at Karl Landsteiner, said in an interview with CURE®.

Bergmeister mentioned that women with breast cancer who are anemic or taking blood thinners do not need to completely steer clear from breast reconstruction, especially since these conditions can be treated.

“Breast reconstruction in specialized centers is a safe procedure, that all women (with) breast cancer should be offered. Nowadays, the outcomes are often predictable, but every surgery may have risks. Our study shows that anemia should be identified before surgery and ideally treated beforehand,” he said.

Additionally, patients taking heparin or other blood thinners should have their dosage modified before the procedure, the study authors recommended.

“We believe the most important aspect in breast reconstruction is to discuss expectations with your breast surgeon. Nowadays, we have various breast reconstruction techniques, and every patient should find the best individual reconstruction. Knowing an individual’s risk factors helps in defining a personalized treatment,” Bergmeister said.

Finding and following through with a plan for breast reconstruction can not only ensure the best outcomes, but also improve quality of life for women with breast cancer.

READ MORE: Navigating the Ins and Outs of Implant Reconstruction After Breast Cancer Surgery

“Numerous studies have shown the benefit of breast reconstruction to overcome the psychological burden of breast cancer,” he concluded. “We want to rehabilitate women back into their life before cancer and restore their body integrity. Thus, this study was important to furthermore improve breast reconstruction, reduce risks and provide women with the best outcomes.”

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