Combined autologous breast reconstruction and gynecologic procedures: Does timing affect clinical and patient-reported outcomes? Journal Article


Authors: Coleman-Belin, J. C.; Kim, M.; Graziano, F. D.; Boe, L. A.; Khavanin, N.; Massand, S.; Nelson, J. A.; Allen, R. J.
Article Title: Combined autologous breast reconstruction and gynecologic procedures: Does timing affect clinical and patient-reported outcomes?
Abstract: Background: Patients with or at risk for breast cancer may opt for risk-reducing gynecologic surgeries, including bilateral salpingo-oophorectomies and/or total abdominal hysterectomy. The timing and safety of combining these procedures with autologous breast reconstruction (ABR) are debated. This study assesses the impact of concurrent ABR and gynecologic surgeries on clinical and patient-reported outcomes. Methods: Female patients who underwent ABR from 2010 to 2023 were included. Three groups were compared: (1) same-day ABR with gynecologic surgery, (2) staged ABR and gynecologic surgery, and (3) ABR alone. Clinical and patient-reported outcomes included operative time, length of stay (LOS), complications, return to the operating room, and BREAST-Q Physical Well-Being of the Abdomen scores. Results: A total of 2288 patients were included. Of these, 66 had simultaneous surgeries (Group 1), 256 had staged surgeries (Group 2), and 1966 had ABR alone (Group 3). There were no meaningful differences in operative time, return to the operating room, LOS, or overall complication rates. Seroma occurrence was significantly lower in Group 3 than Group 2 (6.1% vs. 6.3% vs. 3.5%; p = 0.046) which emerged during pairwise comparisons. BREAST-Q Physical Well-Being of the Abdomen scores did not significantly differ among the three cohorts at preoperative, 6-month postoperative, and 1-year postoperative time points. Conclusion: The findings indicate that simultaneous ABR and gynecologic surgeries do not significantly impact complication rates, operative times, hospital stays, or patient-reported abdominal well-being, supporting that simultaneous surgery as a safe and efficient approach for appropriate patients. © 2024 Wiley Periodicals LLC.
Keywords: hysterectomy; breast reconstruction; microsurgery; complications; patient reported outcome measures; diep flap; autologous breast reconstruction; salpingo-oophrectomy
Journal Title: Journal of Surgical Oncology
Volume: 131
Issue: 7
ISSN: 0022-4790
Publisher: Wiley Blackwell  
Date Published: 2025-06-01
Start Page: 1400
End Page: 1406
Language: English
DOI: 10.1002/jso.28048
PUBMED: 39737812
PROVIDER: scopus
DOI/URL:
Notes: The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PubMed record and PDF. Corresponding MSK author is Robert J. Allen -- Source: Scopus
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MSK Authors
  1. Robert J Allen Jr
    101 Allen Jr
  2. Jonas Allan Nelson
    217 Nelson
  3. Lillian Augusta Boe
    73 Boe
  4. Minji Kim
    38 Kim