Top

World Journal of Surgery

Published in:

Open Access 01-03-2011

Partial Mastectomy and M. Latissimus Dorsi Reconstruction for Radiation-induced Fibrosis After Breast-conserving Cancer Therapy

Authors: Albertus N. van Geel, Titia E. Lans, Roel Haen, Rudi Tjong Joe Wai, Marian B. E. Menke-Pluijmers

Published in: World Journal of Surgery | Issue 3/2011

Abstract

Background

Patients with severe complaints of radiation-induced fibrosis after breast-conserving therapy and not responding to conservative therapy, were treated by partial mastectomy and m. latissimus dorsi reconstruction.

Method

To determine the feasibility and outcome of this approach, a retrospective study of nine patients was carried out.

Results

After a mean follow-up of 46 months, eight of the nine patients experienced improvement of their complaints and shape of the breast. In only one case did the procedure fail, as evidenced by continuation of all complaints.

Conclusions

Partial mastectomy and m. latissimus dorsi reconstruction is the ultimate option in the treatment of radiation fibrosis. The procedure is safe with satisfying results.

National Cancer Institute (2007) Cancer trends progress report—2007. National Cancer Institute, Bethesda

Hill RP, Rodemann HP, Hendry JH et al (2001) Normal tissue radiobiology: from the laboratory to the clinic. Int J Radiat Oncol Biol Phys 49:353–365CrossRefPubMed

Bentzen SM, Overgaard M, Thames HD (1989) Fractionation sensitivity of a functional endpoint: impaired shoulder movement after post-mastectomy radiotherapy. Int J Radiat Oncol Biol Phys 17:531–537CrossRefPubMed

Overgaard M, Bentzen SM, Christensen JJ et al (1987) The value of the NSD formula in equation of acute and late radiation complications in normal tissue following 2 and 5 fractions per week in breast cancer patients treated with postmastectomy irradiation. Radiother Oncol 9:11CrossRef

Fisher B, Anderson S, Redmond CK et al (1995) Reanalysis and results after 12 years of follow-up in a randomized clinical trial comparing total mastectomy with lumpectomy with or without irradiation in the treatment of breast cancer. N Engl J Med 333:1456–1461CrossRefPubMed

Chen PY, Vicini FA, Benitez P et al (2006) Long-term cosmetic results and toxicity after accelerated partial-breast irradiation: a method of radiation delivery by interstitial brachytherapy for the treatment of early-stage breast carcinoma. Cancer 106:991–999CrossRefPubMed

Hammond DC (2008) Postmastectomy reconstruction of the breast using the latissimus dorsi musculocutaneous flap. Cancer J 14:248–252CrossRefPubMed

Hernanz F, Regano S, Redondo-Figuero C et al (2007) Oncoplastic breast-conserving surgery: analysis of quadrantectomy and immediate reconstruction with latissimus dorsi flap. World J Surg 31:1934–1940CrossRefPubMed

Spear SL, Boehmler JH, Taylor NS et al (2007) The role of the latissimus dorsi flap in reconstruction of the irradiated breast. Plast Reconstr Surg 119:1–9CrossRefPubMed

10.

Bentzen SM, Overgaard M (1993) Early and late normal tissue injury after postmastectomy radiotherapy. Recent Results Cancer Res 130:59–78PubMed

11.

Marinus J, Niel CG, de Bie RA et al (2000) Measuring radiation fibrosis: the interobserver reliability of two methods of determining the degree of radiation fibrosis. Int J Radiat Oncol Biol Phys 47:1209–1217CrossRefPubMed

12.

Wernicke AG, Rosenblatt R, Rasca M et al (2009) Quantitative assessment of radiation-induced fibrosis of the breast with tissue compliance meter, palpation, and radiological imaging: preliminary results. Breast J 15:583–592CrossRefPubMed

13.

Zimmermann JS, Kimmig B (1998) Pharmacological management of acute radiation morbidity. Strahlenther Onkol 174(Suppl 3):62–65PubMed

14.

Campana F, Zervoudis S, Perdereau B et al (2004) Topical superoxide dismutase reduces post-irradiation breast cancer fibrosis. J Cell Mol Med 8:109–116CrossRefPubMed

15.

Gottlober P, Steinert M, Bahren W et al (2001) Interferon-gamma in 5 patients with cutaneous radiation syndrome after radiation therapy. Int J Radiat Oncol Biol Phys 50:159–166CrossRefPubMed

16.

Coleman CN, Kelly L, Riese Daly N et al (2002) Phase III study of ibuprofen versus placebo for radiation-induced genitourinary side effects. Int J Radiat Oncol Biol Phys 54:191–194PubMed

17.

Dion MW, Hussey DH, Doornbos JF et al (1990) Preliminary results of a pilot study of pentoxifylline in the treatment of late radiation soft tissue necrosis. Int J Radiat Oncol Biol Phys 19:401–407CrossRefPubMed

18.

Delanian S, Lefaix JL (2004) The radiation-induced fibroatrophic process: therapeutic perspective via the antioxidant pathway. Radiother Oncol 73:119–131CrossRefPubMed

19.

Gothard L, Cornes P, Earl J et al (2004) Double-blind placebo-controlled randomised trial of vitamin E and pentoxifylline in patients with chronic arm lymphoedema and fibrosis after surgery and radiotherapy for breast cancer. Radiother Oncol 73:133–139CrossRefPubMed

20.

Feldmeier JJ, Hampson NB (2002) A systematic review of the literature reporting the application of hyperbaric oxygen prevention and treatment of delayed radiation injuries: an evidence based approach. Undersea Hyperb Med 29:4–30PubMed

Title: Partial Mastectomy and M. Latissimus Dorsi Reconstruction for Radiation-induced Fibrosis After Breast-conserving Cancer Therapy
Authors: Albertus N. van Geel
Titia E. Lans
Roel Haen
Rudi Tjong Joe Wai
Marian B. E. Menke-Pluijmers
Publication date: 01-03-2011
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 3/2011
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-010-0911-8

At a glance: The STEP trials

Springer Medicine

Partial Mastectomy and M. Latissimus Dorsi Reconstruction for Radiation-induced Fibrosis After Breast-conserving Cancer Therapy

Abstract

Background

Method

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Method

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 3/2011

Angiointervention: High Rates of Failure Following Blunt Renal Injuries

Clinicopathologic Characteristics of Colorectal Cancer Patients with Synchronous and Metachronous Gastric Cancer

Current Management of Cervical Esophageal Cancer

Validation of the World Health Organization Tool for Situational Analysis to Assess Emergency and Essential Surgical Care at District Hospitals in Ghana

Laparoscopic Organ-Sparing Resection of Von Hippel-Lindau Disease-Associated Pancreatic Neuroendocrine Tumors

Hyperbaric Oxygen Therapy: Solution for Difficult to Heal Acute Wounds? Systematic Review