Document Detail

Current status of implant-based breast reconstruction in patients receiving postmastectomy radiation therapy.
MedLine Citation:
PMID:  23018711     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Increasing numbers of patients with breast cancer are being treated with postmastectomy radiation therapy. The author reviewed the literature to determine the clinical impact of this increasing use of postmastectomy radiation therapy in patients with breast cancer who desire implant-based breast reconstruction.
METHODS: The author searched the MEDLINE database for articles on breast reconstruction and radiation therapy published between January of 2008 and June of 2011 and reviewed the abstracts of those articles to identify articles with information about the impact of irradiation on implant-based breast reconstruction. This subgroup of articles was reviewed in detail.
RESULTS: Two hundred eighty-five articles were identified. Nineteen articles were reviewed in detail. Eight articles provided level III evidence; one provided level I or II evidence from high-quality multicenter or single-center randomized controlled trials or prospective cohort studies. Two articles provided level IV evidence from case series and were included in the review because they offered a novel approach or perspective. The most recent studies find a significant need for unplanned or major corrective surgery in irradiated breasts reconstructed with implants. Although breast implant reconstruction in irradiated breasts is associated with high rates of complications, only a minority of patients require conversion to an autologous tissue flap.
CONCLUSION: Although the majority of patients who undergo implant-based reconstruction and irradiation ultimately keep the implant reconstruction, patient surveys show that irradiation has a significantly negative effect on patient satisfaction.
Steven J Kronowitz
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, N.I.H., Extramural; Review    
Journal Detail:
Title:  Plastic and reconstructive surgery     Volume:  130     ISSN:  1529-4242     ISO Abbreviation:  Plast. Reconstr. Surg.     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-09-28     Completed Date:  2012-12-14     Revised Date:  2014-10-13    
Medline Journal Info:
Nlm Unique ID:  1306050     Medline TA:  Plast Reconstr Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  513e-523e     Citation Subset:  AIM; IM    
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MeSH Terms
Breast Implants / adverse effects*
Breast Neoplasms / radiotherapy*,  surgery
Graft Rejection
Graft Survival
Mammaplasty / adverse effects*,  methods
Mastectomy / methods
Middle Aged
Patient Safety
Postoperative Care / methods
Postoperative Complications / physiopathology,  surgery
Radiotherapy, Adjuvant / adverse effects
Risk Assessment
Surgical Flaps
Treatment Outcome
United States
Wound Healing / physiology
Grant Support
Comment In:
Plast Reconstr Surg. 2013 May;131(5):849e   [PMID:  23629128 ]
Plast Reconstr Surg. 2012 Oct;130(4):524e-525e   [PMID:  23018712 ]
Plast Reconstr Surg. 2013 May;131(5):848e-9e   [PMID:  23629127 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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