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. 2015 Aug 10;3(7):e473.
doi: 10.1097/GOX.0000000000000436. eCollection 2015 Jul.

Can an Immediate 2-stage Breast Reconstruction Be Performed After Previous Conservative Surgery and Radiotherapy?

T C Lam  1 , F Hsieh  1 , J Salinas  1 , J Boyages  1
Affiliations

Can an Immediate 2-stage Breast Reconstruction Be Performed After Previous Conservative Surgery and Radiotherapy?

T C Lam et al. Plast Reconstr Surg Glob Open. .

Abstract

Background: Prosthetic breast reconstruction is generally considered contraindicated after previous breast irradiation. As a result, patients undergoing a salvage mastectomy for recurrent breast cancer or "risk-reducing" mastectomies after previous conservative surgery and radiotherapy (CS + RT) are usually offered autologous breast reconstruction. However, not all such patients are suitable candidates for a major flap reconstruction. The purpose of this study is to review our results of immediate 2-stage prosthetic breast reconstruction after CS + RT.

Methods: A retrospective review was undertaken for 671 consecutive patients with prosthetic-only breast reconstruction performed by a single surgeon over a 12.5-year period. Twenty-two patients who qualified for the criteria were audited. Outcomes examined include complications, loss of tissue expander or implant, revisional surgery, and aesthetic result.

Results: Twenty-two patients underwent 33 mastectomies and immediate 2-stage breast reconstructions after previous CS + RT (15 for recurrent cancer and seven "risk-reduction") and 11 contralateral risk-reducing mastectomies. One patient died due to extensive metastatic disease. There was no reconstruction failure. The average breast implant size was 491.7 g (range 220 -685g). Seroma was the most common complication and occurred in 3 of 22 patients (13.6%) after stage 1 and 3 of 21 patients (14.3%) after stage 2 reconstruction. The revisional surgery rate was 28.6%. Aesthetic result was rated as excellent in 9.5%, good in 76.2%, and fair in 14.3%.

Conclusions: For selected patients, immediate 2-stage prosthetic breast reconstruction can be performed successfully after a salvage mastectomy subsequent to a recurrence after CS + RT.

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Conflict of interest statement

Disclosure: The authors have no financial interest to declare in relation to the content of this article. The Article Processing Charge was paid for by Dr. Lam.

Figures

Fig. 1.
Fig. 1.
Thirty-year-old woman 7 years after bilateral mastectomies and 2-stage immediate breast reconstruction for recurrent left breast cancer after prior conservative surgery and radiotherapy.
Fig. 2.
Fig. 2.
Forty-two-year-old patient 5 years after right mastectomy and immediate breast reconstruction for recurrent breast cancer after prior conservative surgery and radiotherapy.
See this image and copyright information in PMC

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