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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 4/2019

01-04-2019 | Mastectomy | Breast Oncology

The Impact of Radiotherapy on Reoperation Rates in Patients Undergoing Mastectomy and Breast Reconstruction

Authors: Li Zhang, MD, Kairui Jin, MD, Xuanyi Wang, MD, Zhaozhi Yang, MD, Junqi Wang, MD, Jinli Ma, MD, Xin Mei, MD, Xingxing Chen, PhD, Xiaofang Wang, PhD, Zhirui Zhou, PhD, Jurui Luo, PhD, Jiong Wu, MD, Zhimin Shao, MD, Zhen Zhang, MD, Xiaoli Yu, MD, Xiaomao Guo, MD

Published in: Annals of Surgical Oncology | Issue 4/2019

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Abstract

Objective

The aim of this study was to determine the impact of postmastectomy radiotherapy (PMRT) on reoperation rates in women with breast cancer undergoing mastectomy and breast reconstruction.

Methods

Between June 2001 and December 2015, 832 breast cancer patients treated with mastectomy and breast reconstruction with (n = 159) or without (n = 673) PMRT were analyzed retrospectively. Reoperations following breast reconstruction were categorized into the following three types: anticipated, unanticipated, and others. Multivariable logistic regression models were used to evaluate the impact of PMRT on overall and unanticipated reoperations according to different breast reconstruction types after adjusting for relevant covariates.

Results

With a median follow-up of 58.5 months, a total of 1298 operations were performed in 832 breast cancer patients. The rates of overall and unanticipated reoperations were 46.2% and 7.7%, respectively. Multivariable analysis showed that PMRT was not associated with overall reoperations in either implant-based reconstruction patients (odds ratio [OR] 1.00, 95% confidence interval [CI] 0.43–2.37, p = 0.995) or autologous reconstruction patients (OR 0.85, 95% CI 0.52–1.40, p = 0.533); however, the impact of PMRT on unanticipated reoperations differed by reconstruction type. In patients who received implant-based reconstructions, PMRT was associated with a 3.05-fold (95% CI 1.20–7.75, p = 0.019) higher odds of unanticipated reoperations, while there was no difference in patients who underwent autologous reconstruction (OR 1.17, 95% CI 0.51–2.66, p = 0.713). Delayed reconstruction or delayed–immediate reconstructions were associated with an increased risk of both overall and unanticipated reoperations in both reconstruction cohorts.

Conclusions

PMRT appears to be associated with an increased risk of unanticipated reoperations among patients receiving implant-based reconstruction, but not among those receiving autologous reconstruction. The risk of reoperation should be taken into consideration when selecting the appropriate breast reconstruction type when PMRT is planned.
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Metadata
Title
The Impact of Radiotherapy on Reoperation Rates in Patients Undergoing Mastectomy and Breast Reconstruction
Authors
Li Zhang, MD
Kairui Jin, MD
Xuanyi Wang, MD
Zhaozhi Yang, MD
Junqi Wang, MD
Jinli Ma, MD
Xin Mei, MD
Xingxing Chen, PhD
Xiaofang Wang, PhD
Zhirui Zhou, PhD
Jurui Luo, PhD
Jiong Wu, MD
Zhimin Shao, MD
Zhen Zhang, MD
Xiaoli Yu, MD
Xiaomao Guo, MD
Publication date
01-04-2019
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 4/2019
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-018-07135-4

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