Document Detail

A prospective longitudinal study of cosmetic outcome in immediate latissimus dorsi breast reconstruction and the influence of radiotherapy.
MedLine Citation:
PMID:  18224376     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Immediate breast reconstruction may result in superior cosmetic outcomes as a result of the preservation of the skin envelope. The impact of implant use and radiotherapy (RT) on the cosmetic outcome of latissimus dorsi (LD) breast reconstruction, however, has never been prospectively evaluated with adequate long-term follow-up. METHODS: Women undergoing immediate LD breast reconstruction from January 2000 to February 2007 underwent photographic assessment and clinical evaluation for breast retraction analysis (BRA) at 3, 6 and 12 months postoperatively and on the anniversary of their surgery. The resulting photographs were subject to panel cosmetic assessment. A patient-reported cosmetic outcome questionnaire and the body image scale (BIS) were administered to each woman at a single time point to coincide with the anniversary of their surgery. Multilevel linear regression modelling was used to analyse the results. RESULTS: Seventy-three women underwent 53 implant-assisted LD breast reconstructions and 20 autologous procedures with a mean follow-up of 2.71 years. The incidence of radiotherapy in this cohort was 43%. RT over time adversely influenced overall cosmetic outcome as assessed by the panel (P = 0.0002), and BRA (P = 0.033), both of which were significantly worse in the implant-assisted group (P = 0.020). Patient reporting of overall cosmetic outcome and BIS, however, did not differ significantly between the LD groups or following RT. CONCLUSION: Radiotherapy may adversely affect the cosmetic outcome of latissimus dorsi breast reconstruction, particularly if an implant is used, but this is not universal. Patient assessment of their cosmetic outcome may, however, differ significantly from the clinician's view.
Helen Jane Thomson; Shelley Potter; Rosemary Jane Greenwood; Amit Bahl; Jane Barker; Simon John Cawthorn; Zoë Ellen Winters
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Publication Detail:
Type:  Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't     Date:  2008-01-26
Journal Detail:
Title:  Annals of surgical oncology     Volume:  15     ISSN:  1534-4681     ISO Abbreviation:  Ann. Surg. Oncol.     Publication Date:  2008 Apr 
Date Detail:
Created Date:  2008-03-11     Completed Date:  2008-04-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9420840     Medline TA:  Ann Surg Oncol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1081-91     Citation Subset:  IM    
Department of Clinical Sciences at South Bristol and Bristol Breast Unit, Level 7 Research, Bristol Royal Infirmary, Marlborough Street, Bristol, BS2 8HW, UK.
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MeSH Terms
Breast Implants / adverse effects
Breast Neoplasms / radiotherapy*,  surgery*
Cosmetic Techniques
Middle Aged
Muscle, Skeletal / transplantation*
Patient Satisfaction
Prospective Studies
Radiotherapy, Adjuvant / adverse effects*

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

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