Post-mastectomy breast reconstruction in patients with a history of breast-conserving surgery (BCS) and radiotherapy is challenging with a paucity of literature on the outcomes of different breast reconstructive techniques. We hypothesized that implant-based breast reconstruction (IBR) would be associated with higher complication rates compared to either IBR combined with latissimus dorsi (LD) or free flap breast reconstruction (FFBR).

We conducted a retrospective review of patients who underwent mastectomy with a prior history of BCS and radiotherapy between January 2000 and March 2016. Surgical and patient-reported outcomes (BREAST-Q) were compared between IBR vs. IBR/LD vs. FFBR.

In patients with prior BCS and radiotherapy, FFBR was associated with lower probability of reconstruction failure compared to IBR but no significant difference in overall and major complication rates. The addition of LD flap to IBR did not translate into lower complication rates but may result in decreased reconstruction failures. 

Read the full article here: https://pubmed.ncbi.nlm.nih.gov/36332081/