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Title: Postmastectomy Chest Wall Radiation to a Temporary Tissue Expander or Permanent Breast Implant-Is There a Difference in Complication Rates?

Abstract

Purpose: The purpose of this study was to evaluate the likelihood of complications and cosmetic results among breast cancer patients who underwent modified radical mastectomy (MRM) and breast reconstruction followed by radiation therapy (RT) to either a temporary tissue expander (TTE) or permanent breast implant (PI). Methods and Materials: Records were reviewed of 74 patients with breast cancer who underwent MRM followed by breast reconstruction and RT. Reconstruction consisted of a TTE usually followed by exchange to a PI. RT was delivered to the TTE in 62 patients and to the PI in 12 patients. Dose to the reconstructed chest wall was 50 Gy. Median follow-up was 48 months. The primary end point was the incidence of complications involving the reconstruction. Results: There was no significant difference in the rate of major complications in the PI group (0%) vs. 4.8% in the TTE group. No patients lost the reconstruction in the PI group. Three patients lost the reconstruction in the TTE group. There were excellent/good cosmetic scores in 90% of the TTE group and 80% of the PI group (p = 0.22). On multivariate regression models, the type of reconstruction irradiated had no statistically significant impact on complication rates. Conclusions:more » Patients treated with breast reconstruction and RT can experience low rates of major complications. We demonstrate no significant difference in the overall rate of major or minor complications between the TTE and PI groups. Postmastectomy RT to either the TTE or the PI should be considered as acceptable treatment options in all eligible patients.« less

Authors:
 [1]; ; ;  [2];  [3]; ;  [4]
  1. Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States), E-mail: p_anderson@fccc.edu
  2. Department of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States)
  3. Department of Biostatistics, Fox Chase Cancer Center, Philadelphia, PA (United States)
  4. Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA (United States)
Publication Date:
OSTI Identifier:
21276774
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 74; Journal Issue: 1; Other Information: DOI: 10.1016/j.ijrobp.2008.06.1940; PII: S0360-3016(08)03052-6; Copyright (c) 2009 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CHEST; IMPLANTS; MAMMARY GLANDS; MULTIVARIATE ANALYSIS; NEOPLASMS; PATIENTS; RADIATION DOSES; RADIOTHERAPY

Citation Formats

Anderson, Penny R., Freedman, Gary, Nicolaou, Nicos, Sharma, Navesh, Li Tianyu, Topham, Neal, and Morrow, Monica. Postmastectomy Chest Wall Radiation to a Temporary Tissue Expander or Permanent Breast Implant-Is There a Difference in Complication Rates?. United States: N. p., 2009. Web. doi:10.1016/j.ijrobp.2008.06.1940.
Anderson, Penny R., Freedman, Gary, Nicolaou, Nicos, Sharma, Navesh, Li Tianyu, Topham, Neal, & Morrow, Monica. Postmastectomy Chest Wall Radiation to a Temporary Tissue Expander or Permanent Breast Implant-Is There a Difference in Complication Rates?. United States. doi:10.1016/j.ijrobp.2008.06.1940.
Anderson, Penny R., Freedman, Gary, Nicolaou, Nicos, Sharma, Navesh, Li Tianyu, Topham, Neal, and Morrow, Monica. Fri . "Postmastectomy Chest Wall Radiation to a Temporary Tissue Expander or Permanent Breast Implant-Is There a Difference in Complication Rates?". United States. doi:10.1016/j.ijrobp.2008.06.1940.
@article{osti_21276774,
title = {Postmastectomy Chest Wall Radiation to a Temporary Tissue Expander or Permanent Breast Implant-Is There a Difference in Complication Rates?},
author = {Anderson, Penny R. and Freedman, Gary and Nicolaou, Nicos and Sharma, Navesh and Li Tianyu and Topham, Neal and Morrow, Monica},
abstractNote = {Purpose: The purpose of this study was to evaluate the likelihood of complications and cosmetic results among breast cancer patients who underwent modified radical mastectomy (MRM) and breast reconstruction followed by radiation therapy (RT) to either a temporary tissue expander (TTE) or permanent breast implant (PI). Methods and Materials: Records were reviewed of 74 patients with breast cancer who underwent MRM followed by breast reconstruction and RT. Reconstruction consisted of a TTE usually followed by exchange to a PI. RT was delivered to the TTE in 62 patients and to the PI in 12 patients. Dose to the reconstructed chest wall was 50 Gy. Median follow-up was 48 months. The primary end point was the incidence of complications involving the reconstruction. Results: There was no significant difference in the rate of major complications in the PI group (0%) vs. 4.8% in the TTE group. No patients lost the reconstruction in the PI group. Three patients lost the reconstruction in the TTE group. There were excellent/good cosmetic scores in 90% of the TTE group and 80% of the PI group (p = 0.22). On multivariate regression models, the type of reconstruction irradiated had no statistically significant impact on complication rates. Conclusions: Patients treated with breast reconstruction and RT can experience low rates of major complications. We demonstrate no significant difference in the overall rate of major or minor complications between the TTE and PI groups. Postmastectomy RT to either the TTE or the PI should be considered as acceptable treatment options in all eligible patients.},
doi = {10.1016/j.ijrobp.2008.06.1940},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 1,
volume = 74,
place = {United States},
year = {2009},
month = {5}
}