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Implant breast reconstruction after radiation therapy for breast cancer
In
our article published in Plastic and Reconstructive Surgery a
retrospective review was performed of patients who underwent tissue
expansion and implant breast reconstruction performed by a single surgeon
after mastectomy for breast carcinoma from 1996 to 2003. Complications and
aesthetic results were compared between women who received radiation
therapy and those who did not. A
total of 104 patients (123 breasts) who underwent mastectomy and implant
breast reconstruction were included in the study. Twenty-seven patients
(27 breasts) received either premastectomy or postmastectomy radiotherapy
for breast carcinoma. All women who received radiation therapy did so
before completion of their implant reconstruction. Complications
ultimately requiring prosthetic device removal or replacement and total
complications were more frequent in breasts that received radiation than
breasts that did not (18.5 percent versus 4.2 percent for complications
requiring prosthetic removal or replacement and 40.7 percent versus 16.7
percent for total complications). Breast symmetry was significantly better
in women who did not receive radiotherapy compared with those who did. Implant
breast reconstruction in patients who receive radiotherapy is possible but
associated with more frequent complications and decreased aesthetic
results. However, the present results compare favorably to those reported
in prior articles: this may be attributable to the use of newer prostheses,
staged breast reconstruction with initial tissue expansion, total muscular
coverage of the implant and modern radiotherapy protocols. Bibliographical
reference: Jeffrey AschermanDivision
of Plastic Surgery, Department of Surgery, Columbia University Medical
Center, New York, NY, USA
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