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. 2018 May 21;13(5):e0197615.
doi: 10.1371/journal.pone.0197615. eCollection 2018.

Objective assessment of flap volume changes and aesthetic results after adjuvant radiation therapy in patients undergoing immediate autologous breast reconstruction

Yujin Myung  1 , Yousung Son  1 , Tae-Hyun Nam  2 , Eunyoung Kang  3 , Eun-Kyu Kim  3 , In Ah Kim  4 , Keun-Yong Eom  4 , Chan Yeong Heo  1 , Jae Hoon Jeong  1
Affiliations

Objective assessment of flap volume changes and aesthetic results after adjuvant radiation therapy in patients undergoing immediate autologous breast reconstruction

Yujin Myung et al. PLoS One. .

Abstract

Background: The use of immediate breast reconstruction and adjuvant radiation therapy is increasing in breast cancer patients. This study aimed to analyze the aesthetic outcome and changes in flap volume in patients with breast cancer undergoing radiation therapy of the surgical site after immediate autologous tissue reconstruction.

Methods: Immediate abdominal free flap breast reconstruction following unilateral mastectomy was performed in 42 patients; 21 patients received adjuvant radiation (study group) and 21 patients did not (control group). To compare flap volume, three-dimensional computed tomography (CT) was performed before and after radiation. Also, aesthetic analysis was performed in both groups to evaluate shape changes.

Results: There was a 12.3% flap volume reduction after the completion of radiation in the experimental group that was significantly greater than the 2.6% volume reduction observed in the non-radiation group (P<0.01). There was no significant difference in the short- and long-term aesthetic results between the groups.

Conclusions: When performing immediate autologous breast reconstruction, 14% volume overcorrection is recommended for patients in whom adjuvant radiation therapy is anticipated to improve aesthetic outcomes.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Volumetric analysis.
(A) Three-dimensional reconstructed image of chest computed tomographic study. (B) Outline of abdominal flap was manually marked in each scan image.
Fig 2
Fig 2. Reconstructed images of the flap.
Anterior view and lateral view of reconstructed images.
Fig 3
Fig 3. Photographic image of a patient.
(A) 43-year old patient 4 weeks after nipple-sparing mastectomy and immediate breast reconstruction with a free transverse rectus abdominis flap. (B) After completion of adjuvant radiation therapy. (C) One year after the completion of radiation therapy. Increased symmetry and a decrease in the upper part of the reconstructed breast is observed.
Fig 4
Fig 4. Breast cosmesis analysis.
Breast cosmesis assessment using the Breast Cancer Conservative Treatment (BCCT)-core program.
See this image and copyright information in PMC

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