Postmastectomy radiation therapy and breast reconstruction: an analysis of complications and patient satisfaction.
The indications for postmastectomy radiotherapy (PMRT) have expanded over the past decade. This study examines PMRT and reconstruction compared with a control group without radiotherapy. There were 919 reconstructed breasts identified (1999-2006) and separated into 3 groups: mastectomy with PMRT before reconstruction (n = 57), immediate reconstruction then PMRT (n = 59), and reconstruction without PMRT (n = 665). A validated questionnaire assessed patient satisfaction (response rate 73.7%). Overall complication rates for patients undergoing PMRT (before and after reconstruction) were higher than that of the controls (39.66% vs. 23.16%, P < 0.001). Immediate reconstruction before PMRT had increased overall and late (>90 days) complication rates, compared with controls (47.46% vs. 23.16%, P < 0.001; 33.90% vs. 15.59%, P < 0.001, respectively); however general and aesthetic satisfaction was similar. In contrast, PMRT before reconstruction has similar complication rates and general satisfaction with controls, but decreased aesthetic satisfaction (50% vs. 66.88%, P < 0.035).
Lee
Bernard T
BT
Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA. blee3@bidmc.harvard.edu
A Adesiyun
Tolulope
T
Colakoglu
Salih
S
Curtis
Michael S
MS
Yueh
Janet H
JH
E Anderson
Katarina
K
Tobias
Adam M
AM
Recht
Abram
A
D000328:Adult; D001943:Breast Neoplasms / Q000523:psychology / Q000532:radiotherapy* / Q000601:surgery*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods*; D008408:Mastectomy; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology*; D013524:Surgical Flaps; D011795:Surveys and Questionnaires; D016896:Treatment Outcome