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Postmastectomy radiation therapy and two-stage implant-based breast reconstruction. Is there a better time to irradiate?
- Publication Year :
- 2017
- Publisher :
- Lippincott Williams and Wilkins, 2017.
-
Abstract
- Background: The ideal timing of postmastectomy radiation therapy (PMRT) in the setting of two-stage implant-based breast reconstruction remains unclear. In this cohort study, the authors sought to determine whether complication rates differed between patients who received PMRT following tissue expander placement (TE-XRT) and those who received PMRT after exchange for permanent implants (Implant-XRT) utilizing using prospective, multicenter data. Methods: Eligible patients in the Mastectomy Reconstruction Outcomes Consortium study from 11 institutions across North America were included in the analysis. All patients had at least 6-month follow-up after their last intervention (i.e., implant exchange for TE-XRT patients, and radiation for Implant-XRT patients). Complications including seroma, hematoma, infection, wound dehiscence, capsular contracture, and implant loss were recorded. Results: The authors identified a total of 150 patients who underwent immediate, two-stage implant-based breast reconstruction and received PMRT. Of these, there were TE-XRT 104 patients (69.3 percent) and 46 (30.7 percent) Implant-XRT patients. There were no differences in the incidence of any complications or complications leading to reconstructive failure between the two cohorts. After adjusting for patient characteristics and site effect, the timing of PMRT (i.e., TE-XRT versus Implant-XRT) was not a significant predictor in the development of any complication, a major complication, or reconstructive failure. Conclusion: In the setting of PMRT and two-stage implant-based reconstruction, patients who received PMRT after expander placement (TE-XRT) did not have a higher incidence or increased odds of developing complications than those who received PMRT after exchange for a permanent implant (Implant-XRT). CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
- Subjects :
- Adult
medicine.medical_specialty
Adolescent
Mammaplasty
Breast Implants
medicine.medical_treatment
Tissue Expansion
Breast Neoplasms
030230 surgery
Article
Young Adult
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
medicine
Humans
Prospective Studies
Stage (cooking)
Prospective cohort study
Breast Implantation
Mastectomy
Retrospective Studies
Aged
Aged, 80 and over
Wound dehiscence
business.industry
Incidence
Tissue Expansion Devices
Capsular contracture
Middle Aged
Postmastectomy radiation
medicine.disease
Surgery
Radiation therapy
Logistic Models
Treatment Outcome
030220 oncology & carcinogenesis
Seroma
Linear Models
Female
Radiotherapy, Adjuvant
Radiology
Implant
Breast reconstruction
business
Follow-Up Studies
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....6429e345a5b1e6431ca7a76fc0d704c6