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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 3/2010

01-10-2010 | American Society of Breast Surgeons

Complication Rates of Radiation on Tissue Expander and Autologous Tissue Breast Reconstruction

Authors: Tiffany Berry, MD, Suzanne Brooks, MD, Nicole Sydow, MD, Risal Djohan, MD, Benjamin Nutter, MD, Joanne Lyons, MD, Jill Dietz, MD

Published in: Annals of Surgical Oncology | Special Issue 3/2010

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Abstract

Background

To evaluate risk factors for complications of tissue expander/implant and autologous tissue breast reconstructions and determine if radiation increases complication rates.

Materials and Methods

We performed a retrospective review of patients who underwent mastectomy plus autologous tissue or expander/implant reconstruction at the Cleveland Clinic. Univariate and multivariate analysis were performed in each group to evaluate for risk factors for complications. A complication was considered major if it required reoperation. A predictive model was used to compare the 2 groups to one another.

Results

A total of 1037 patients were included in the study. In the tissue expander/implant population, there was a total complication rate of 31.8% and overall major complication rate of 24.4%. Radiation increased the major complication rate from 21.2 to 45.4%. However, 70.1% of the radiated patients ultimately had a successful implant-based reconstruction while an additional 10.3% went on to have autologous reconstruction. Age and body mass index (BMI) > 30 also led to higher major complication rates in tissue expander/implant reconstruction while smoking, hypertension, and chemotherapy had no impact. In the autologous reconstruction group, there was a total complication rate of 31.5% and a major complication rate of 19.7%. There was no statistically significant difference between the radiated and nonradiated autologous tissue reconstructions with major complication rates of 17.9 and 20.5%, respectively. BMI > 30 was the only significant factor leading to higher major complications in the autologous reconstructions.

Conclusion

Total complication rates were similar between tissue expander and autologous reconstructions. Increased major complication rates in patients with tissue expander reconstructions occurred in those with radiation, but was still successful in the majority of patients. Radiation had no influence on autologous tissue reconstruction major complication rates.
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Metadata
Title
Complication Rates of Radiation on Tissue Expander and Autologous Tissue Breast Reconstruction
Authors
Tiffany Berry, MD
Suzanne Brooks, MD
Nicole Sydow, MD
Risal Djohan, MD
Benjamin Nutter, MD
Joanne Lyons, MD
Jill Dietz, MD
Publication date
01-10-2010
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue Special Issue 3/2010
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-010-1261-3

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