Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2015 Aug;22(8):2551-9.
doi: 10.1245/s10434-014-4326-x. Epub 2015 Jan 7.

Immediate Reconstruction of the Radiated Breast: Recent Trends Contrary to Traditional Standards

Shailesh Agarwal  1 , Kelley M Kidwell, Aaron Farberg, Jeffrey H Kozlow, Kevin C Chung, Adeyiza O Momoh
Affiliations

Immediate Reconstruction of the Radiated Breast: Recent Trends Contrary to Traditional Standards

Shailesh Agarwal et al. Ann Surg Oncol. 2015 Aug.

Abstract

Background: Immediate, implant-only breast reconstruction is traditionally discouraged in patients who receive radiation. It is not clear whether this widely recognized mantra of breast reconstruction is observed in practice. The purpose of this study was to evaluate immediate reconstruction trends and practices in patients who have undergone mastectomy and radiation therapy.

Methods: Female patients with unilateral breast cancer who required radiation in addition to mastectomy were extracted from the Surveillance, Epidemiology, and End Results (SEER) database from 2000 through 2010. Patients who underwent immediate reconstruction were identified and analyzed. Univariate and logistic regression analyses were performed to study the relationship between reconstructive method and patient demographic and oncologic characteristics.

Results: A total of 5,481 female patients who underwent radiation and breast reconstruction were included for analysis. Postmastectomy radiation therapy was performed in 98.3 % of the patients. The immediate breast reconstruction rate among patients requiring radiation increased from 13.6 to 25.1 %. The percentage of reconstructed patients who had implant-only reconstruction increased from 27 to 52 % (p < 0.001) with a decrease in tissue-only reconstruction from 56 to 32 % (p < 0.001). In regression analysis, the odds of implant reconstruction over autologous reconstruction increased each year by an odds ratio of 1.13 (95 % CI 1.10-1.15).

Conclusions: The frequency of immediate reconstruction continues to increase in the setting of postmastectomy radiation therapy, with immediate implant-based reconstruction representing the most commonly utilized method, contrary to traditional recommendations. These findings likely reflect changing attitudes towards implant reconstruction in the setting of planned postmastectomy radiation.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Immediate Breast Reconstruction Rate from 2000–2010 in Patients Requiring Radiation. (6,875 reconstructions/40,568 women with BC)
Figure 2
Figure 2
Reconstruction Rates by Method in Radiated Patients from 2000–2010 out of all specified reconstructions
See this image and copyright information in PMC

References

    1. Jagsi R, Jiang J, Momoh AO, et al. Trends and variation in use of breast reconstruction in patients with breast cancer undergoing mastectomy in the United States. Journal of clinical oncology: official journal of the American Society of Clinical Oncology. 2014;32:919–26. - PMC - PubMed
    1. Prabhu R, Godette K, Carlson G, et al. The impact of skin-sparing mastectomy with immediate reconstruction in patients with Stage III breast cancer treated with neoadjuvant chemotherapy and postmastectomy radiation. International journal of radiation oncology, biology, physics. 2012;82:e587–93. - PubMed
    1. Behranwala KA, Dua RS, Ross GM, Ward A, A’Hern R, Gui GP. The influence of radiotherapy on capsule formation and aesthetic outcome after immediate breast reconstruction using biodimensional anatomical expander implants. Journal of plastic, reconstructive & aesthetic surgery: JPRAS. 2006;59:1043–51. - PubMed
    1. Christante D, Pommier SJ, Diggs BS, et al. Using complications associated with postmastectomy radiation and immediate breast reconstruction to improve surgical decision making. Archives of surgery. 2010;145:873–8. - PubMed
    1. Hirsch EM, Seth AK, Dumanian GA, et al. Outcomes of tissue expander/implant breast reconstruction in the setting of prereconstruction radiation. Plastic and reconstructive surgery. 2012;129:354–61. - PubMed

Publication types

LinkOut - more resources