Immediate breast reconstruction with anatomical implants following mastectomy: The radiation perspective

Journal Article · Fri Jul 01 04:00:00 EDT 2016 · Medical Dosimetry

DOI:https://doi.org/10.1016/J.MEDDOS.2015.11.002· OSTI ID:22577875

Ben-David, Merav ^[1]; Granot, Hila ^[1]; Gelernter, Ilana ^[2]; Scheflan, Michael ^[3]

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1. Radiation Oncology Unit, Chaim Sheba Medical Center, Ramat Gan (Israel)
2. Statistical Laboratory, School of Mathematics, Tel Aviv University, Tel Aviv (Israel)
3. Department of Surgery, Assuta and Herzliya Medical Centers, Ramat Gan (Israel)

Immediate implant-based breast reconstruction followed by postmastectomy radiation therapy (PMRT) is controversial because of the risk of compromised treatment plans and concerns regarding cosmetic outcomes. We evaluated the effects of immediate direct-to-implant breast reconstruction with anatomical implants on the quality of PMRT delivered by 3-dimensional conformal radiotherapy (3D-CRT). In this retrospective, single-institution study, patients who had undergone reconstruction with direct anatomic implant, performed by a single surgeon, received 3D-CRT between 2008 and 2013. For each patient, 2 plans (including or excluding internal mammary nodes [IMN]) were created and calculated. The primary end point was the dose distribution among reconstructed breasts, heart, lungs, and IMNs, and between right and left breasts. Of 29 consecutive patients, 11 received right-sided and 18 received left-sided PMRT to a total dose of 50 Gy. For plans excluding IMN coverage, mean D{sub mean} for right and left reconstructed breasts was 49.09 Gy (98.2% of the prescribed dose) and 48.51 Gy (97.0%), respectively. For plans including IMNs, mean D{sub mean} was 49.15 Gy (98.3%) for right and 48.46 Gy (96.9%) for left reconstructed breasts; the mean IMN D{sub mean} was 47.27 Gy (right) and 47.89 Gy (left). Heart D{sub mean} was below 1.56 Gy for all plans. Mean total lung volume receiving a dose of ≥ 20 Gy was 13.80% to 19.47%. PMRT can be delivered effectively and safely by 3D-CRT after direct-to-implant breast reconstruction with anatomical implants, even if patients require IMN treatment.

• OSTI ID: 22577875
• Journal Information: Medical Dosimetry, Journal Name: Medical Dosimetry Journal Issue: 2 Vol. 41; ISSN 0958-3947
• Country of Publication: United States
• Language: English

Related Subjects

61 RADIATION PROTECTION AND DOSIMETRY
62 RADIOLOGY AND NUCLEAR MEDICINE
HEALTH HAZARDS
HEART
IMPLANTS
LUNGS
MAMMARY GLANDS
PATIENTS
RADIATION DOSE DISTRIBUTIONS
RADIATION DOSES
RADIOTHERAPY