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Strahlentherapie und Onkologie

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01-12-2012 | Original article

Expander/implant breast reconstruction before radiotherapy

Outcomes in a single-institute cohort

Authors: C. Aristei, MD, L. Falcinelli, V. Bini, I. Palumbo, A. Farneti, R.P. Petitto, S. Gori, E. Perrucci

Published in: Strahlentherapie und Onkologie | Issue 12/2012

Abstract

Background and purpose

Radiotherapy (RT) of reconstructed breasts was associated with major complications and poor cosmetic outcome. The present study assessed complication rates, the link between risk factors and prosthesis removal, as well as cosmetic outcomes.

Patients and methods

From 1997 to 2009, 101 consecutive patients received RT after breast reconstruction because of risk factors for relapse (92) or because relapse had occurred (9). At RT, 90 patients had temporary tissue expanders and 11 had permanent implants. Twelve patients underwent neo-adjuvant chemotherapy; all patients received adjuvant chemo- and/or hormone therapy.

Results

At a median follow-up of 50 months, late toxicities occurred in 28 patients: pain in 7, lymphedema in 6, G1 cutaneous toxicity in 5, and subcutaneous toxicity in 19 (2G1, 9G2, 7G3, 1G4), with more than one side effect in 12. In 8 patients the prosthesis ruptured (3), was displaced (3), was displaced and ruptured (1), or lost shape (1). Capsular contracture was classified in 89 patients as IA in 14, IB in 47, II in 10, III in 11, and IV in 7. Twelve prostheses (11.9%) were removed. The only significant factor for prosthesis removal was age (p = 0.007). Judgments of cosmetic results were available from 81 physicians and 84 patients. Outcome was excellent/good in 58/81 physician judgments and in 57/84 patient evaluations. Overall inter-rater agreement on outcome was good (κ-value 0.64; 95% CI: 0.48–0.79).

Conclusion

RT to reconstructed breasts was associated with low rates of late toxicity and prosthesis removal. Cosmetic outcomes were, on the whole, good to excellent.

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Title: Expander/implant breast reconstruction before radiotherapy
Outcomes in a single-institute cohort
Authors: C. Aristei, MD
L. Falcinelli
V. Bini
I. Palumbo
A. Farneti
R.P. Petitto
S. Gori
E. Perrucci
Publication date: 01-12-2012
Publisher: Springer-Verlag
Published in: Strahlentherapie und Onkologie / Issue 12/2012
Print ISSN: 0179-7158
Electronic ISSN: 1439-099X
DOI: https://doi.org/10.1007/s00066-012-0231-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Expander/implant breast reconstruction before radiotherapy

Outcomes in a single-institute cohort

Abstract

Background and purpose

Patients and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background and purpose

Patients and methods

Results

Conclusion

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