Comparisons of resource costs and success rates between immediate and delayed breast reconstruction using DIEP or SIEA flaps under a well-controlled clinical trial

Background: Every year many patients diagnosed with breast cancer are subjected to mastectomy. Some of them choose to undergo breast reconstruction to restore their body image. Immediate or delayed reconstruction is possible, depending on medical, financial, and emotional considerations. High success rate and cost-effectiveness are two important factors that may guide decision making in the management plan. The objective of this study was to compare the resource costs and success rates of immediate and delayed breast reconstructions using either deep inferior epigastric perforator (DIEP) or superficial inferior epigastric artery (SIEA) flaps. The resource cost is referred to as the cost of operation and hospitalization. Methods: From September of 2000 through August of 2001, 42 patients underwent immediate (n = 21) or delayed (n = 21) unilateral breast reconstruction using either a DIEP (n = 30) or SIEA (n = 12) flap by one surgeon. Results: There were no statistical differences in resource costs, success, and complication rates between DIEP and SIEA flaps in both the immediate and delayed breast reconstruction groups. Conclusions: Using either a DIEP or SIEA flap as the autologous tissue, delayed breast reconstruction is as cost-effective as immediate reconstruction.