title: Delayed breast implant reconstruction: is radiation therapy associated with capsular contracture or reoperations?
abstract: We evaluated the association between radiation therapy and severe capsular contracture or reoperation after 717 delayed breast implant reconstruction procedures (288 1- and 429 2-stage procedures) identified in the prospective database of the Danish Registry for Plastic Surgery of the Breast during the period between 1999 and 2006. A history of radiation therapy was associated with increased risk of severe capsular contracture for 1- and 2-stage procedures, with adjusted hazard ratios (HR) of 3.3 (95% confidence interval [CI]: 0.9-12.4) and 7.2 (95% CI: 2.4-21.4), respectively. Similarly, a history of radiation therapy was associated with a non-significantly increased risk of reoperation after both 1-stage (HR = 1.4; 95% CI: 0.7-2.5) and 2-stage (HR = 1.6; 95% CI: 0.9-3.1) procedures. Reconstruction failure was highest (13.2%) in the 2-stage procedures with a history of radiation therapy. Breast reconstruction approaches other than implants should be seriously considered among women who have received radiation therapy.
authors.affiliation: Institute of Cancer Epidemiology, Danish Cancer Society, Strandboulevarden 49, Copenhagen, Denmark. hvilsom@cancer.dk
authors.forename: Gitte Bjørn
authors.initials: GB
authors.lastname: Hvilsom
authors.forename: Lisbet Rosenkrantz
authors.initials: LR
authors.lastname: Hölmich
authors.forename: Marianne
authors.initials: M
authors.lastname: Steding-Jessen
authors.forename: Kirsten
authors.initials: K
authors.lastname: Frederiksen
authors.forename: Trine Foged
authors.initials: TF
authors.lastname: Henriksen
authors.forename: Loren
authors.initials: L
authors.lastname: Lipworth
authors.forename: Joseph
authors.initials: J
authors.lastname: McLaughlin
authors.forename: Jens Jørgen
authors.initials: JJ
authors.lastname: Elberg
authors.forename: Tine Engberg
authors.initials: TE
authors.lastname: Damsgaard
authors.forename: Søren
authors.initials: S
authors.lastname: Friis
mesh_terms: D000328:Adult; D001940:Breast / Q000601:surgery; D019928:Breast Implantation / Q000009:adverse effects / Q000706:statistics & numerical data; D018427:Breast Implants / Q000009:adverse effects / Q000706:statistics & numerical data*; D001943:Breast Neoplasms / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D015984:Causality; D015331:Cohort Studies; D015897:Comorbidity; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D057910:Implant Capsular Contracture / Q000453:epidemiology* / Q000209:etiology; D016462:Mammaplasty / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D011878:Radiotherapy / Q000009:adverse effects* / Q000706:statistics & numerical data*; D012042:Registries; D012086:Reoperation; D012307:Risk Factors; D013997:Time Factors