Clinical Outcomes of Postmastectomy Radiation Therapy After Immediate Breast Reconstruction

Journal Article · Sat Nov 01 04:00:00 EDT 2008 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2008.01.055· OSTI ID:21128220

Rush, Stephen C ^[1]; Kostroff, Karen ^[2]; Derisi, Dwight ^[3]; Farber, Leonard A ^[1]; Maurer, Virginia E ^[4]; Bosworth, Jay L ^[1]

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1. Department of Radiation Oncology, Long Island Radiation Therapy, Garden City, NY (United States)
2. Department of Surgery, Long Island Jewish Hospital, New Hyde Park, NY (United States)
3. Department of Surgery, North Shore University Hospital, Manhasset, NY (United States)
4. Department of Surgery, Winthrop University Hospital, Mineola, NY (United States)

Purpose: To determine the long-term complication rates and cosmetic results for patients undergoing postmastectomy radiation therapy (PMRT) after immediate reconstruction (IR). Methods and Materials: Between January 1998 and December 2005, 92 patients underwent modified radical mastectomy, IR, and PMRT in our practice. A total of 69 patients underwent tissue expander and implant reconstruction (TE/I), and 23 underwent autologous tissue reconstruction (ATR). Follow-up regarding complications and cosmesis was obtained for all 92 patients. Complications were scored as follows: Grade 1, no discomfort; Grade 2, discomfort affecting activities of daily living; Grade 3, surgical intervention or intravenous antibiotics required; and Grade 4, removal or replacement of the reconstruction. Cosmesis was rated as either acceptable or unacceptable to the patient. Both complications and cosmesis were correlated with treatment- and patient-related factors. Results: Median follow-up for all patients was 38 months. The overall rate of severe complications (Grade 3-4) was 25%. The overall rate of poor functional results (Grade 2-4) was 43.4%. When analyzed as a function of type of reconstruction, the rate of Grade 3 to 4 complications was 33.3% for TE/I vs. 0% for ATR (p = 0.001). The rate of Grade 2 to 4 complications was 55% for TE/I vs. 8.7% for ATR (p < 0.001). Acceptable cosmesis was reported in 51% of TE/I patients vs. 82.6% of ATR patients (p = 0.007). No other treatment or patient-related factors had a significant impact on either complications or cosmesis. Conclusion: In patients undergoing PMRT after IR, ATR is associated with fewer long-term complications and better cosmetic results than TE/I.

• OSTI ID: 21128220
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 3 Vol. 72; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
ANTIBIOTICS
CARCINOMAS
IMPLANTS
MAMMARY GLANDS
PATIENTS
RADIOTHERAPY
SURGERY