Breast Reconstruction Following Breast Cancer Surgery in Sudanese Women in Khartoum State 2022

Yousif, Aya; Dabora, Muaweyia; Mahmoud, Shadad; Mohamed, Nagla

doi:10.21608/ejprs.2025.405205

	Breast Reconstruction Following Breast Cancer Surgery in Sudanese Women in Khartoum State 2022
The Egyptian Journal of Plastic and Reconstructive Surgery
Article 7, Volume 49, Issue 1, January 2025, Pages 47-56 PDF (800.89 K)
DOI: 10.21608/ejprs.2025.405205
Authors
Aya Yousif^* ¹; Muaweyia Dabora²; Shadad Mahmoud¹; Nagla Mohamed¹
¹The Departments of Plastic and Reconstructive Surgery, Soba University Hospital, Khartoum, Sudan
²National Ribat University, Khartoum, Sudan
Abstract
Background: Breast reconstruction after cancer surgery is crucial for women’s psychological well-being and quality of life. Many advances were made in reconstructive techniques allowing it to become a common practice worldwide. Aim of the Work: The aim of this study is to determine the rate, type and timing of breast reconstruction in Sudanese women. Patients and Methods: This is a descriptive cross-sectional multi-centric hospital-based study involving the medical records of all adult females with breast reconstruction following breast cancer surgery in Khartoum locality from June 2020 to June 2022. Results: A total of 305 women had mastectomies during the two-year study period, 46 (14.8%) of them had unilateral breast reconstruction, the majority of which 30 (65.2%) were done using autologous techniques, while 11 breast (23.9%) had implant reconstruction, 5 (10.9%) had partial reconstruction using oncoplastic techniques. The most autologous technique used was LD flap reconstruction 21 breasts (70%), followed by TRAM flap in 8 (26.67%) and DIEP flap in 1 (3.33%) in 41 (89.13%) the reconstruction was done immediately. Conclusion: In this study, the rate of post-mastectomy breast reconstruction is low with mostly immediate autologous technique used. Raising awareness about breast reconstruction and increasing cooperation with the general surgeons are some of the ways to resolve this issue.
Keywords
Breast reconstruction; Oncoplastic breast surgery; Latissimus Dorsi flap; TRAM

References
1- Who.int. 2021.breast cancer. {online} available at: >https://WWW.WHO.int/news-room/fact-sheets/detail/ breast cancer< 2- Dean C., Chetty U. and Forrest A.: Effects of immediate breast reconstruction on psychosocial morbidity after mastectomy. The Lancet, 321 (8322): pp. 459-462, 1983. 3- Guyomard V., Leinster S. and Wilkinson M.: Systemic review of studied patient’s satisfaction with breast reconstruction after mastectomy. The breast, 16 (6): pp.547- 567, 2007. 4- Jończyk J. and Jankau J.: The Assessment of Early Complications and Risk Factors Affecting Their Occurrence in Breast Reconstructive Procedures. Indian Journal of Surgery, 2021. 5- Morrow M., Li Y., Alderman A., Jagsi R., Hamilton A., Graff J., et al.: Access to Breast Reconstruction After Mastectomy and Patient Perspectives on Reconstruction Decision Making. JAMA Surgery, 149 (10): 1015, 2014. 6- Wireko A.A., Wellington J., Adebusoye F.T., Tenkorang P.O., Ahmad A.O. and Abdul-Rahman T.: Breast cancer in Africa: An extensive surgical burden of paramount importance - letter to the editor. Int. J. Surg., Mar 1; 109 (3): 651-652, 2023. doi: 10.1097/JS9.0000000000000253. PMID: 37093103; PMCID: PMC10389489. 7- Abdelsamie Abdalla Mohamed, Kamal Eldein H. Mohamed, Eltaib A. Saad and Shadad M. Mahmoud: “The Response, Operability, and Type of Surgery Following Neoadjuvant Chemotherapy in Sudanese Patients with Locally Advanced Breast Cancer,” Sudan Journal of Medical Sciences, Vol. 13, Issue No. 3, pages 219–229, 2018. DOI 10.18502/sjms. v13i3.2961. 8- Liu J., Zheng X., Lin S., Han H. and Xu C.: Breast conserving therapy for central breast cancer in the United States. BMC Surg. [Internet], 22 (1): 31, 2022. Available from: http://dx.doi.org/10.1186/s12893-022-01488-0. 9. Song W.J., Kang S.G., Kim E.K., Song SY, Lee J.S., Lee J.H., et al.: Current status of and trends in post-mastectomy breast reconstruction in Korea. Arch Plast Surg [Internet], 47 (2): 118–25, 2020. Available from: http://dx.doi. org/10.5999/aps.2019.01676. 10- Feng Y., Flitcroft K., van Leeuwen M.T., Elshaug A.G., Spillane A. and Pearson S-A.: Patterns of immediate breast reconstruction in New South Wales, Australia: A population- based study. ANZ J Surg [Internet]. [cited 2023 Feb. 18]; 89 (10): 1230–5, 2019. Available from: http://dx.doi. org/10.1111/ans.15381. 11- Gichuru S., Kedera T., Wanjeri J. and Ndaguatha P.: Predictors of post-mastectomy breast reconstruction in Kenya. Ann Afr Surg. [Internet]. [cited 2023 Feb 18]; 17 (1), 2020. Available from: https://www.ajol.info/index.php/ aas/article/view/192991. Egypt, J. Plast. Reconstr. Surg., January 2025 55 12- Maudgal S, Rajagopal J, Huilgol N. and Yadav P.: Challenges in India about breast cancer and breast reconstruction. Breast [Internet]. [cited 2023 Feb 18]; 41: S9, 2018. Available from: https://www.thebreastonline.com/article/ S0960-9776(18)30169-3/fulltext. 13- Sim N., Soh S., Ang CH, Hing C.H., Lee H.J., Nallathamby V., et al.: Breast reconstruction rate and profile in a Singapore patient population: A National University Hospital experience. Singapore Med. J. [Internet]. 59 (6): 300–4, 2018. Available from: http://dx.doi.org/10.11622/ smedj.2017035. 14- Retrouvey H., Solaja O., Gagliardi A.R., Webster F. and Zhong T.: Barriers of access to breast reconstruction: A systematic review: A systematic review. Plast. Reconstr. Surg. [Internet]. [cited 2023 Feb 18]; 143 (3): 465e–76e, 2019. Available from: https://pubmed.ncbi.nlm.nih. gov/30817637/. 15- Ranganathan K., Ogunleye A.A., Aliu O., Agbenorku P. and Momoh A.O.: Breast reconstruction practices and barriers in West Africa: A survey of surgeons: A survey of surgeons. Plast. Reconstr. Surg. Glob Open [Internet]. [cited 2023 Feb 18]; 8 (11): e3259, 2020. Available from: http:// dx.doi.org/10.1097/GOX.0000000000003259. 16- DeCoster R.C., Bautista R-MF Jr., Burns J.C., Dugan A.J., Edmunds R.W., Rinker BD, et al.: Rural-urban differences in breast reconstruction utilization following oncologic resection. J Rural Health [Internet]. 36 (3): 347–54, 2020. Available from: http://dx.doi.org/10.1111/jrh.12396. 17- Régis C., Le J., Chauvet M-P., Le Deley M-C. and Le Teuff G.: Variations in the breast reconstruction rate in France: A nationwide study of 19,466 patients based on the French medico-administrative database. Breast [Internet]. 42: 74– 80, 2018. Available from: https://www.sciencedirect.com/ science/article/pii/S0960977618301395. 18- Butler P.D., Familusi O., Serletti J.M. and Fox J.P.: Influence of race, insurance status, and geographic access to plastic surgeons on immediate breast reconstruction rates. Am J Surg [Internet]. [cited 2023 Feb 18]; 215 (6): 987–94, 2018. Available from: https://pubmed.ncbi.nlm. nih.gov/29103529/. 19- Qin Q., Tan Q., Lian B., Mo Q., Huang Z. and Wei C.: Postoperative outcomes of breast reconstruction after mastectomy: A retrospective study. Medicine (Baltimore) [Internet]. 97 (5): e9766, 2018. Available from: http://dx. doi.org/10.1097/MD.0000000000009766. 20- Hart S.E. and Momoh A.O.: Breast reconstruction disparities in the United States and internationally. Curr Breast Cancer Rep [Internet]. 12 (3): 132–9, 2020. Available from: http://dx.doi.org/10.1007/s12609-020-00366-z. 21- Avino A., Răducu L., Brînduşe L.A., Jecan C-R. and Lascăr I.: Timing between breast reconstruction and oncologic mastectomy-one center experience. Medicina (Kaunas) [Internet]. [cited 2023 Feb 18]; 56 (2): 86, 2020. Available from: http://dx.doi.org/10.3390/medicina56020086. 22- Ito H., Ueno T., Suga H., Shiraishi T., Isaka H., Imi K., et al.: Risk factors for skin flap necrosis in breast cancer patients treated with mastectomy followed by immediate breast reconstruction. World J. Surg. [Internet]. 43 (3): 846–52, 2019. Available from: http://dx.doi.org/10.1007/ s00268-018-4852-y. 23- Kim J-W., Lee J-H., Kim T-G., Kim Y-H. and Chung K.J.: Breast reconstruction statistics in Korea from the Big Data Hub of the Health Insurance Review and Assessment Service. Arch Plast Surg [Internet]. 45 (5): 441–8, 2018. Available from: http://dx.doi.org/10.5999/aps.2018.00220. 24- Wilkins E.G., Hamill J.B., Kim H.M., Kim J.Y., Greco R.J., Qi J., et al.: Complications in postmastectomy breast reconstruction: One-year outcomes of the mastectomy reconstruction outcomes consortium (MROC) study. Ann. Surg. [Internet]. 267 (1): 164–70, 2018. Available from: http://dx.doi.org/10.1097/sla.0000000000002033. 25- Yang B., Ren G., Song E., Pan D., Zhang J., Wang Y., et al.: Current status and factors influencing surgical options for breast cancer in China: A nationwide cross-sectional survey of 110 hospitals. Oncologist [Internet]. [cited 2023 Feb 18]; 25 (10): e1473–80, 2020. Available from: http:// dx.doi.org/10.1634/theoncologist.2020-0001. 26- Jonczyk MM, Jean J, Graham R, Chatterjee A. Surgical trends in breast cancer: a rise in novel operative treatment options over a 12 year analysis. Breast Cancer Res Treat [Internet]. 2019 [cited 2023 Feb 18];173(2):267–74. Available from: https://pubmed.ncbi.nlm.nih.gov/30361873/ 27- Bennett K.G., Qi J., Kim H.M., Hamill J.B., Pusic A.L. and Wilkins E.G.: Comparison of 2-year complication rates among common techniques for postmastectomy breast reconstruction. JAMA Surg [Internet]. [cited 2023 Feb 18];153 (10): 901–8, 2018. Available from: https://pubmed. ncbi.nlm.nih.gov/29926077/. 28- Banda C.H., Wilson E., Malata C.M., Narushima M., Ogawa T., Hassanein Z.M., et al.: Clinical application and outcomes of reconstructive microsurgery in Africa: A systematic review and meta-analysis. J Plast Reconstr Aesthet Surg [Internet]. [cited 2023 Feb 18];75 (7): 2035–48, 2022. Available from: https://www.jprasurg.com/article/ S1748-6815(22)00221-2/fulltext. 29- Yoon A.P., Qi J., Brown DL, Kim H.M., Hamill J.B., Erdmann- Sager J., et al.: Outcomes of immediate versus delayed breast reconstruction: Results of a multicenter prospective study. Breast [Internet]. 37: 72–9, 2018. Available from: http://dx.doi.org/10.1016/j.breast.2017.10.009. 30- Susini T., Renda I., Giani M., Vallario A., Nori J., Vanzi E., et al.: Changing trends in mastectomy and breast reconstruction. Analysis of a single-institution experience between 2004-2016. Anticancer Res. [Internet]. 39 (10): 5709–14, 2019. Available from: http://dx.doi. org/10.21873/anticanres.13770. 31- Siotos C., Lagiou P., Cheah M.A., Bello R.J., Orfanos P., Payne R.M., et al.: Determinants of receiving immediate breast reconstruction: An analysis of patient characteristics at a tertiary care center in the US. Surg. Oncol. [Internet]. 34: 1–6, 2020. Available from: http://dx.doi.org/10.1016/j. suronc.2020.02.017. Vol. 49, No. 1 / Breast Reconstruction Following B 56 reast Cancer Surgery 32- Hong K.Y., Son Y., Chang H. and Jin U.S.: Trends in breast reconstruction: Implications for the National Health Insurance Service. Arch Plast Surg [Internet]. [cited 2023 Feb 18]; 45 (3): 239–45, 2018. Available from: https://pubmed. ncbi.nlm.nih.gov/29788687/. 33- Berlin N.L., Tandon V.J., Qi J, Kim H.M., Hamill J.B., Momoh A.O., et al.: Hospital variations in clinical complications and patient-reported outcomes at 2 years after immediate breast reconstruction. Ann. Surg. [Internet]. [cited 2023 Feb 18]; 269 (5): 959–65, 2019. Available from: https://pubmed.ncbi.nlm.nih.gov/29489482/. 34- Matar D.Y., Wu M, Haug V., Orgill D.P. and Panayi A.C.: Surgical complications in immediate and delayed breast reconstruction: A systematic review and meta-analysis. J. Plast. Reconstr. Aesthet. Surg. [Internet]. 2022 [cited 2023 Feb 18]; 75 (11): 4085–95. Available from: https://www. jprasurg.com/article/S1748-6815(22)00470-3/fulltext 35- Santosa K.B., Qi J., Kim H.M., Hamill J.B., Pusic A.L. and Wilkins E.G.: Effect of Patient Age on Outcomes in Breast Reconstruction: Results from a Multicenter Prospective Study. J. Am. Coll. Surg., Dec. 223 (6): 745-754, 2016. doi: 10.1016/j.jamcollsurg.2016.09.003. Epub 2016 Oct 26. PMID: 27806906; PMCID: PMC5124383.
Statistics Article View: 56 PDF Download: 64