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Master Thesis

Reconstruction mammaire post-mastectomie chez les patientes âgées de 70 ans et plus : évaluation de la population opérable et de la population opérée

Abstract : Background: the incidence of breast cancer in France in 2018 is 58459 new cases. The average age of diagnosis is 61 years old. Thirty percent of patients must have a total mastectomy. The breast reconstruction (BR) rate at any age is 22.9%. Objective: the main objective of our study is to evaluate the operable population and the operated population in terms of BR in women aged 70 and over who had a mastectomy. Methods: this is an unicentric multivariate retrospective study including patients aged 70 and over who had a mastectomy between 2005 and 2018 at the Institut Bergonié. The population was divided into two groups: patients with BR or without BR. For each group, we described the demographic and medical data, the rate of reconstruction proposal issued by the surgeon, the rate of refusal from the surgeon or the patient, the degree of satisfaction regarding the fact of doing a BR or not. Results: 578 patients underwent total mastectomy. 59 patients received BR, 10.21%. 262 women were included, 59 with reconstruction and 201 without reconstruction. Factors influencing positively BR were age less than 75 years, OMS score less than 2, G8 score greater than 14, the absence of anticoagulant treatment, the mastectomy for ductal carcinoma in situ, the proposal issued by the surgeon. Patients with BR expressed satisfaction at 87.5%. Causes of regret were the impact of surgery, presence of complications and the aesthetic result. In patients without BR, 43.8% received a proposal from their surgeon, 38.8% refused a reconstruction with major causes: feeling aged, medical weariness, fear of intervention and no need. 25.87% of non-reconstructed patients expressed regret. Conclusion: despite the advanced age of many patients express a desire for RM. It is important to inform them of the various surgical techniques and their possible complications in order to establish a target population eligible for reconstruction and to limit the number of regrets.
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Audrey Marroc. Reconstruction mammaire post-mastectomie chez les patientes âgées de 70 ans et plus : évaluation de la population opérable et de la population opérée. Sciences du Vivant [q-bio]. 2019. ⟨dumas-02492694⟩

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