Introduction: Breast cancer is the most common invasive neoplasm in women. When taken to mastectomy, breast reconstruction is an integral part of treatment. Objectives: The purpose of this study is to determine which factors are associated to post-operatory complications of breast reconstruction in patients with breast cancer treated with mastectomy. Methods: 306 patients taken to breast reconstruction were divided into three groups depending on technique: pedicled flaps, prosthetic material and deep inferior epigastric perforators (DIEP). Descriptive and comparative statistics were performed to find associations between the type of reconstruction and complications. Results: The factors associated to general were bleeding and reintervention. Reintervention was associated to loss of reconstruction. Factors associated to reoperation were immediate complications, late complications, and radiotherapy. Factors associated to loss of reconstruction where smoker status, presence of late complications, and reintervention. Conclusion: There is a higher percentage of immediate complications and loss of reconstruction with prosthetics. DIEP is an alternative with lower probability of loss of reconstruction. Multidisciplinary teams should establish the decision of the best type of reconstruction.

Conflicto de intereses: los autores declaran no tener conflicto de intereses.

No abstract

BACKGROUND: BREAST-Q is a patient-reported outcome (PRO) that has been designed to evaluate perception outcomes among women undergoing different types of breast surgery, the modules include evaluation for mastectomy, breast reconstruction, augmentation, reduction/mastopexy and breast-conserving therapy. OBJECTIVES: Generate a translated version that is conceptually equivalent to the original version and to validate for Mexican population. METHODS: A linguistic and psychometric validation was performed in 494 women. We carry out pre and postoperative test. Reliability and internal consistency were performed by Cronbach's alpha and intraclass correlation coefficient (ICC). RESULTS: The results of patient testing, number of participants, acceptability and reliability are shown in table 1. The average scores were in all cases >0.80. Summary of BREAST-Q validation analysisN =494Module=nMean age(range)Time to completion Test(minutes) average(range)Time to completion Retest(minutes) average(range)Number of itemsNumber of missing itemsCronbach's Alpha min-max*Test-Retest ICC min-max*Mastectomy=160Pre=6248(26-76)7.8(2-20)6.4(3-20)3700.81-0.940.72-0.94Post=9852(32-78)13(4-40)11(4-28)6310.87-0.970.87-0.96Breast Conserving Therapy=153Pre=8150(21-78)7(2-17)5.2(2-13)3220.88-0.950.82-0.95Post=7255(37-73)18.7(5-44)15.4(6-29)8720.92-0.980.92-0.98Reconstruction=181Pre=6544(23-64)7.9(3-22)6.4(2-20)4220.90-0.970.90-0.97Post=9246(24-74)18.5(8-41)15.7(5-42)11610.86-0.990.85-0.99Lattisimus Dorsi=2445(33-74)5(1-18)4(2-10)1910.95-0.960.96-0.96We report the low and the high value between all sub scales, per questionnaires The internal consistency and reproducibility support the reliability of the instrument; all of the scores were acceptable. DISCUSSION: The importance of measurements quality of life in patient whit cancer, become an essential end-point, we need validated tools that help us improve our performance in different methods of treatments. Is the first validation study of an instrument that measures the impact of surgical treatment on the quality of life of breast cancer patients in Mexico, our results support the equivalent Spanish version for Mexican population. Breast-Q will provide valuable metrics for a surgeon team to document and measure their clinical performance and improve quality of healthcare in our Hispanic patients. CONCLUSIONS: The Mexican Spanish version of tree Modules of Breast-Q is reliable and easy to implement in the population with breast cancer in different scenarios in México with the advantage to measure the quality of life and satisfaction on our population with a locally advanced stage that will help to improve quality of healthcare. The high acceptability of the questionnaire demonstrate that the version is well accepted for our population so we will include a significant number of patient in our country; therefore, more hospital centers will be invited to participate for further studies that allow us to evaluate the population in Latin America and thus compare our results. Citation Format: Bargalló-Rocha J, Gutiérrez-Zacarías L, Gallargo-Alvarado L, Maciel-Miranda J, Shaw-Dulin R, Esparza-Arias N, Figueroa-Padilla J, Vazquez-Romo R, Robles-Vidal C, Drucker-Zertuche M, Cabrera-Galeana P, Cantu-De Leon D. The BREAST-Q: Translation and validation for Mexican population [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-16-07.

Background: Breast cancer (BC) is the most common malignancy in Mexico, and although many Mexican women need breast reconstruction, this is not covered by most public insurance schemes. The National Cancer Institute of Mexico (INCan), located in southern Mexico City provides care to uninsured individuals with all types of malignancies, including BC. In 2012, INCan received a grant from the Mexican federal government in order to establish the “Post-Mastectomy Program” (PMP), aimed at providing free breast reconstruction to women after mastectomy. Here, we describe the implementation and outcomes of our microsurgical breast reconstruction program. Methods: We retrospectively reviewed medical records of all patients undergoing microsurgical breast reconstruction after mastectomy at INCan between the establishment of the PMP in 01/2013 and until 12/2017. Sociodemographic, clinical and surgical characteristics were collected. We also recorded for the presence of complications directly related to the reconstructive procedures, including local complications (infections, necrosis, thrombosis etc.), flap loss, need for reoperation and hospitalization time. Data were analyzed using descriptive statistics such as means, medians and proportions. Results: 161 microsurgical breast reconstructions were conducted at INCan between 01/2013 and 01/2017, ranging from 23 in 2013 to 41 in 2016. Median patient age was 45 years (y) (21-66), and 57% had < high school education. 2.5% had diabetes, 9.9% hypertension, and 2.5% rheumatologic diseases. Median body mass index was 26.8 (18.2-39), 82.6% were non-smokers and 46.5% (n = 108) had previous abdominal scars. Regarding reasons for mastectomy, 67.7% were due to invasive BC, 11.8% to ductal carcinoma in situ, and 5.6% to BRCA mutations. Of the 109 invasive carcinomas, 21.8% were stage I, 57.3% stage II, and 20% stage III; 21.7% received neoadjuvant chemotherapy. 125 patients underwent immediate reconstruction, of which 89 used unilateral deep inferior epigastric perforator flaps (DIEP), 35 bilateral DIEPs, and 1 other technique. Mean preoperatory albumin was 4.2g/dL (SD 0.35), while mean preoperatory hemoglobin was 14.2g/dL (SD 1.2). 41.6% of the patients (n = 67) had at least one surgical complication, with the most common being delayed wound healing in 17% and fat necrosis in 14%. 26% of patients had to be reoperated, and flap loss occurred in 13% (n = 21). No differences were noted in the clinical or surgical characteristics of patients with or without flap loss. Median length of stay was 6 days (range 2-17). Conclusions:This is the first detailed description of the outcomes of a microsurgical reconstruction program in a country with limited resources. Developing and implementing such a program is feasible, and may provide access to breast reconstruction to women who would normally be unable to obtain it. Citation Format: Vargas-Salas D, Figueroa-Padilla J, Soto-Perez-de-Celis E, Maciel-Miranda A, Santamaria E, Zacarías-Gutiérrez LM, Cabrera-Galeana P, Bargallo-Rocha E. Implementation and outcomes of a microsurgical breast reconstruction program at a public cancer center in Mexico [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-16-12.