D63. Oncoplastic Reconstruction in the Setting of Prior Augmentation

PURPOSE: We hypothesized that there would be no difference in the complication, revision, or patient satisfaction rate in patients who maintained their breast augmentation versus those that had their implants removed in the context of oncoplastic breast reconstruction. METHODS: We conducted a retrospective review of 142 patients who underwent lumpectomy and postoperative radiotherapy at a single center from March 2016 to March 2022. The study was limited to patients who had a preexistent cosmetic augmentation at the time of breast cancer diagnosis. Patient factors, reconstructive technique, complications, and revisions were recorded. Patient-reported outcomes were assessed using the BREAST-Q Lumpectomy module. RESULTS: Patients who opted to reduce their implant size and undergo an oncoplastic mastopexy simultaneously had the greatest complication, revision, explantation, and capsular contracture rates amongst all implant management strategies. Maintaining an implant augmentation was not identified as an independent predictor of complications (OR=1.2;95% CI 0.12-13.1;p=0.85) or revisions (OR=1.7;95% CI 0.4-6.6;p=0.45) on multivariate logistic regression. Patient-reported outcomes did not differ significantly between the different implant management cohorts. CONCLUSION: This study demonstrates that maintaining a breast augmentation during lumpectomy+radiotherapy does not increase the risk of complications or revisions and had high patient satisfaction.