title: Risk factors for complications of radiation therapy on tissue expander breast reconstructions.
abstract: Radiation therapy has been shown to increase complication rates of tissue expander/implant breast reconstructions. The purpose of this study was to evaluate patient characteristics to assess their impact on complications. A retrospective review of patients who underwent mastectomy plus tissue expander/implant reconstruction from January 2000 to December 2006 was performed. The main outcome of interest was the development of postoperative complications. Analyses were performed to detect risk factors for complications. A total of 560 patients were included in the study. A total of 385 patients underwent unilateral and 174 underwent bilateral tissue expander/implant reconstructions, for a total of 733 reconstructions. A total complication rate of 31.8% and a major complication rate of 24.4% were calculated. The risk factors associated with a significantly increased incidence of complications were age greater than 50 years, body mass index (BMI) greater than 30, and radiation. Women younger than 50 years had a complication rate of 28.4%, whereas women older than 50 years had a complication rate of 37.0%. Women with a BMI less than 30 had a complication rate of 27.5%, whereas women with a BMI greater than 30 had a complication rate of 49%. The major complication rate in nonradiated and radiated patients was 21.2% and 45.4%, respectively. Despite higher complication rates, tissue expander/implant reconstructions were successful in 70.1% of radiated patients. Based on this study, the ideal radiated patient would have a BMI less than 30 and be younger than 50 years of age to maximize the likelihood of a successful tissue expander/implant reconstruction.
authors.affiliation: OB/GYN and Women's Health Institute, Cleveland, Ohio, 44195, USA. Snbrooks728@yahoo.com
authors.forename: Suzanne
authors.initials: S
authors.lastname: Brooks
authors.forename: Risal
authors.initials: R
authors.lastname: Djohan
authors.forename: Rahul
authors.initials: R
authors.lastname: Tendulkar
authors.forename: Benjamin
authors.initials: B
authors.lastname: Nutter
authors.forename: Joanne
authors.initials: J
authors.lastname: Lyons
authors.forename: Jill
authors.initials: J
authors.lastname: Dietz
mesh_terms: D000367:Age Factors; D015992:Body Mass Index; D019928:Breast Implantation / Q000295:instrumentation / Q000379:methods; D018427:Breast Implants; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008408:Mastectomy; D008875:Middle Aged; D016017:Odds Ratio; D011183:Postoperative Complications / Q000453:epidemiology*; D011878:Radiotherapy / Q000009:adverse effects; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012307:Risk Factors; D015626:Tissue Expansion / Q000295:instrumentation / Q000379:methods; D015625:Tissue Expansion Devices; D016896:Treatment Outcome