Mami Ogita1,2, Naomi Nagura3, Jiro Kawamori4, Reika In3, Atsushi Yoshida3, Hideko Yamauchi3, Junko Takei3, Naoki Hayashi3, Yoshiko Iwahira5, Sachiko Ohde6, Shoko Fukushima4, Kenji Sekiguchi4,7. 1. Department of Radiation Oncology, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan. mamiogi@luke.ac.jp. 2. Department of Radiology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyoku, Tokyo, 113-8655, Japan. mamiogi@luke.ac.jp. 3. Department of Breast Surgical Oncology, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan. 4. Department of Radiation Oncology, St. Luke's International Hospital, 9-1, Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan. 5. Breast Surgery Clinic, 2-21-43, Takanawa, Minato-ku, Tokyo, 108-0074, Japan. 6. Center for Clinical Epidemiology, St. Luke's International University, 3-6-2, Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan. 7. Sonoda-kai Radiation Oncology Clinic, 3-4-19, Hokima, Adachi-ku, Tokyo, 121-0064, Japan.
Abstract
BACKGROUND: The use of post-mastectomy radiotherapy (PMRT) following immediate breast reconstruction has increased recently, and its safety is becoming a major concern. We aimed to evaluate the complication rates of PMRT to immediate tissue-expander/permanent implant (TE/PI)-based reconstructions for breast cancer and its association with radiotherapy timing (irradiation to TE or PI). METHODS: We retrospectively reviewed the cases of breast cancer patients who underwent mastectomy, immediate TE/PI reconstruction, and PMRT between January 2003 and December 2014. The rates of complications including reconstruction failure, re-operation, and infection were estimated by Kaplan-Meier analysis. The risk factors including radiotherapy timing were analyzed by log-rank test and multivariate Cox proportional hazard model. RESULTS: A total of 81 patients were included. Median follow-up was 32 months (range 2-120 months). Radiotherapy consisted of 50 Gy to the reconstructed breast and supraclavicular region in most cases. Total reconstruction failure, re-operation, and infection rates were 12.3, 13.6, and 11.1%, and 5-year cumulative reconstruction failure, re-operation, and infection rates were 16.7, 16.6, and 12.2%, respectively. No significant differences were observed in complication rates with respect to radiotherapy timing. In multivariate analysis, age 55 years and older was a significant risk factor for complications (P < 0.05). CONCLUSION: There were no significant differences in rates of reconstruction failure, re-operation, or infection with regard to radiotherapy timing. PMRT to reconstructed breasts of older patients aged 55 years or over can be expected to result in more complications than in younger patients.
BACKGROUND: The use of post-mastectomy radiotherapy (PMRT) following immediate breast reconstruction has increased recently, and its safety is becoming a major concern. We aimed to evaluate the complication rates of PMRT to immediate tissue-expander/permanent implant (TE/PI)-based reconstructions for breast cancer and its association with radiotherapy timing (irradiation to TE or PI). METHODS: We retrospectively reviewed the cases of breast cancerpatients who underwent mastectomy, immediate TE/PI reconstruction, and PMRT between January 2003 and December 2014. The rates of complications including reconstruction failure, re-operation, and infection were estimated by Kaplan-Meier analysis. The risk factors including radiotherapy timing were analyzed by log-rank test and multivariate Cox proportional hazard model. RESULTS: A total of 81 patients were included. Median follow-up was 32 months (range 2-120 months). Radiotherapy consisted of 50 Gy to the reconstructed breast and supraclavicular region in most cases. Total reconstruction failure, re-operation, and infection rates were 12.3, 13.6, and 11.1%, and 5-year cumulative reconstruction failure, re-operation, and infection rates were 16.7, 16.6, and 12.2%, respectively. No significant differences were observed in complication rates with respect to radiotherapy timing. In multivariate analysis, age 55 years and older was a significant risk factor for complications (P < 0.05). CONCLUSION: There were no significant differences in rates of reconstruction failure, re-operation, or infection with regard to radiotherapy timing. PMRT to reconstructed breasts of older patients aged 55 years or over can be expected to result in more complications than in younger patients.
Entities:
Keywords:
Breast cancer; Breast implant; Post-mastectomy radiotherapy; Prosthetic reconstruction
Authors: Jie Jane Chen; Rie von Eyben; Paulina M Gutkin; Erin Hawley; Frederick M Dirbas; Gordon K Lee; Kathleen C Horst Journal: Ann Surg Oncol Date: 2020-09-01 Impact factor: 5.344
Authors: Víctor Fuertes; Mónica Francés; José M Casarrubios; Javier Fernández-Palacios; Jesús María González; Juan Francisco Loro-Ferrer Journal: Gland Surg Date: 2020-04
Authors: Alfred P Yoon; Ji Qi; Hyungjin M Kim; Jennifer B Hamill; Reshma Jagsi; Andrea L Pusic; Edwin G Wilkins; Jeffrey H Kozlow Journal: Plast Reconstr Surg Date: 2020-05 Impact factor: 5.169
Authors: Gaik Si Quah; James R French; Annelise Cocco; Jeremy Hsu; Farid Meybodi; Elisabeth Elder Journal: Plast Reconstr Surg Glob Open Date: 2019-12-31