Aim:Postmastectomy radiation therapy(PMRT)has played an important role in advanced breast cancer.It may negatively impact the outcomes of implant-based reconstruction.The aim of this study was to investigate the impac...Aim:Postmastectomy radiation therapy(PMRT)has played an important role in advanced breast cancer.It may negatively impact the outcomes of implant-based reconstruction.The aim of this study was to investigate the impact of PMRT on the outcome of implant-based reconstruction.Methods:A total of 36 patients from 2009 to 2019 were included,with 12 in the two-stage group(TE-XRT±Implant),who received PMRT after mastectomy and tissue expander insertion,14 received PMRT after immediate direct-to-implant(DTI-XRT)breast reconstruction,and 10 with history of breast conservation surgery and PMRT received mastectomy and DTI reconstruction for cancer recurrence(XRT-DTI).Morbidities,including acute and late poor wound healing,implant or expander loss,and final revision surgeries,were reviewed.Results:There were no significant differences in age,gender,BMI,or histological type among groups.Overall,complications were higher in the TE-XRT±Implant group than in the DTI-XRT group(83.3%vs.35.7%,P=0.02).Wound breakdown was more frequent in the TE-XRT±Implant group than in the DTI-XRT group(33.3%vs.0.0%,P=0.03).In two-stage reconstruction,implant exposure occurred predominantly in the late stage of the stage Ⅱ surgery and stage Ⅱ surgery tended to present higher overall and late complications than XRT-DTI or DTI-XRT.Conclusion:For patients requiring PMRT,two-stage implant-based breast reconstruction tends to have a higher complication rate than DTI breast reconstruction.Our results suggest that radiation’s impact on wound healing might outweigh other negative effects,and conversion from implant-based reconstruction to two-stage reconstruction may not always be necessary.展开更多
文摘Aim:Postmastectomy radiation therapy(PMRT)has played an important role in advanced breast cancer.It may negatively impact the outcomes of implant-based reconstruction.The aim of this study was to investigate the impact of PMRT on the outcome of implant-based reconstruction.Methods:A total of 36 patients from 2009 to 2019 were included,with 12 in the two-stage group(TE-XRT±Implant),who received PMRT after mastectomy and tissue expander insertion,14 received PMRT after immediate direct-to-implant(DTI-XRT)breast reconstruction,and 10 with history of breast conservation surgery and PMRT received mastectomy and DTI reconstruction for cancer recurrence(XRT-DTI).Morbidities,including acute and late poor wound healing,implant or expander loss,and final revision surgeries,were reviewed.Results:There were no significant differences in age,gender,BMI,or histological type among groups.Overall,complications were higher in the TE-XRT±Implant group than in the DTI-XRT group(83.3%vs.35.7%,P=0.02).Wound breakdown was more frequent in the TE-XRT±Implant group than in the DTI-XRT group(33.3%vs.0.0%,P=0.03).In two-stage reconstruction,implant exposure occurred predominantly in the late stage of the stage Ⅱ surgery and stage Ⅱ surgery tended to present higher overall and late complications than XRT-DTI or DTI-XRT.Conclusion:For patients requiring PMRT,two-stage implant-based breast reconstruction tends to have a higher complication rate than DTI breast reconstruction.Our results suggest that radiation’s impact on wound healing might outweigh other negative effects,and conversion from implant-based reconstruction to two-stage reconstruction may not always be necessary.
