Factors associated with reconstruction failure and major complications following post-mastectomy radiation to a reconstructed breast

Charles T Lee, Karen Ruth, Sameer Patel et al.
Factors associated with reconstruction failure and major complications following post-mastectomy radiation to a reconstructed breast
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Post-mastectomy radiotherapy (PMRT) is known to increase risk of complications in the reconstruction setting. We aim to identify the variables associated with reconstruction failure and other major complications.

A prospectively collected institutional database was queried for patients with up-to stage IIIC breast cancer treated from 2000-2017, undergoing mastectomy, immediate implant or autologous tissue reconstruction, and radiation to the reconstructed breast within 1-year of surgery. Reconstruction failure was defined as complication requiring surgical revision or implant removal. Additional major complications were defined as any infection, contracture, necrosis, or fibrosis. Covariates of interest included age, body mass index, smoking status, stage, hormone receptor and HER2 status, systemic therapy timing, radiation technique, nodal irradiation, and interval between surgery and start of PMRT. Differences in complication rates were assessed with Chi-square or Fishers exact tests. Competing risk regression was used to estimate hazard ratios; covariates were included one at a time to avoid over-adjustment.

Using IMRT may improve reconstruction outcomes over CRT, with significantly lower reconstruction failure and complication rates without compromising local control or survival.

Read the full article here: https://pubmed.ncbi.nlm.nih.gov/36332800/  

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