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

Journal Article · Mon Apr 15 04:00:00 EDT 2019 · Annals of Surgical Oncology (Online)

DOI:https://doi.org/10.1245/S10434-018-07135-4· OSTI ID:22927864

Zhang, Li; Jin, Kairui; Wang, Xuanyi; Yang, Zhaozhi; Wang, Junqi; Ma, Jinli; Mei, Xin; Chen, Xingxing; Wang, Xiaofang; Zhou, Zhirui; Luo, Jurui ^[1]; Wu, Jiong; Shao, Zhimin ^[2]; Zhang, Zhen; Yu, Xiaoli; Guo, Xiaomao ^[1]

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1. Fudan University Shanghai Cancer Center, Department of Radiation Oncology (China)
2. Fudan University, Department of Oncology, Shanghai Medical College (China)

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.

• OSTI ID: 22927864
• Journal Information: Annals of Surgical Oncology (Online), Journal Name: Annals of Surgical Oncology (Online) Journal Issue: 4 Vol. 26; ISSN 1534-4681
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
IMPLANTS
MAMMARY GLANDS
NEOPLASMS
PATIENTS
RADIOTHERAPY
WOMEN