title: The effect of radiotherapy on implant-based breast reconstruction in the setting of skin-sparing mastectomy: clinical series and review of complications.
abstract: BACKGROUND
  With the increasing popularity of skin-sparing mastectomy techniques, implant-based breast reconstruction and use of perioperative radiation therapy, there is a growing need to scrutinize the effects they have on breast reconstruction. This study examined the effect of radiation on implant-based breast reconstruction in patients who had skin-sparing or conventional mastectomies in terms of complication, reoperation, and capsular contracture rates.
  
  
  METHODS
  A retrospective review of 227 implant-based breast reconstructions in 132 mastectomy patients by a single surgeon was undertaken. All cases occurred over a four-year period (2006-2009) at a single institution. Complication, re-operation, and capsular contracture rates were tabulated against immediate and delayed reconstruction, skin-sparing and conventional mastectomy implant-based reconstruction, and irradiated and non-irradiated groups. Chi-square test was performed for statistical analysis.
  
  
  RESULTS
  The overall complication and reoperation rates of 15% and 10% in these 227 reconstructions compare favorably to reviewed series. Delayed reconstruction, skin-sparing mastectomy and irradiation were all associated with a significantly increased rate of re-operation, but not to an increase in complication or capsular contracture rates.
  
  
  CONCLUSIONS
  The results of this study were more favourable than those of similar studies reported in the current literature, suggesting an increased role for implant-based reconstruction in the setting of adjuvant radiotherapy for patients that undergo skin-sparing mastectomy.
authors.affiliation: Department of Plastic, Wound, and Burn Surgery, University of Kansas Medical Center, Kansas City, KC, USA.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Hughes
authors.forename: Charles
authors.initials: C
authors.lastname: Brown
authors.forename: Victor
authors.initials: V
authors.lastname: Perez
authors.forename: Jeannette W C
authors.initials: JW
authors.lastname: Ting
authors.forename: Warren M
authors.initials: WM
authors.lastname: Rozen
authors.forename: Iain S
authors.initials: IS
authors.lastname: Whitaker
authors.forename: Richard
authors.initials: R
authors.lastname: Korentager
mesh_terms: D018427:Breast Implants; D001943:Breast Neoplasms / Q000532:radiotherapy* / Q000601:surgery*; D003131:Combined Modality Therapy / Q000009:adverse effects; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects / Q000379:methods*; D008408:Mastectomy / Q000009:adverse effects / Q000379:methods*; D011878:Radiotherapy / Q000009:adverse effects / Q000379:methods; D012189:Retrospective Studies; D013997:Time Factors