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Complications after breast reconstruction with alloplastic material in breast cancer patients submitted or not to post mastectomy radiotherapy
Authors:Silvia Radwanski Stuart  Alexandre Mendona Munhoz  Cristiane LG Chaves  Eduardo Montag  Thalita CS Cordeiro  Tatiana Taba Fuzisaki  Gustavo N Marta  Heloisa A Carvalho
Institution:1.Department of Radiology and Oncology — Radiotherapy, Instituto do Câncer do Estado de São Paulo (ICESP), Brasil; 2.Instituto de Radiologia (INRAD) — Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brasil; 3.Department of Plastic Surgery, Division of Breast Reconstruction, Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, Brasil
Abstract:Background and purposeBreast reconstruction following mastectomy is a relevant element of breast cancer treatment. The purpose of this study was to evaluate the influence of radiotherapy (RT) on local complications in patients with breast cancer that had undergone breast reconstruction with alloplastic material.Materials and methodsRetrospective study of breast cancer patients submitted to mastectomy and breast reconstruction from 2009 to 2013. Clinical and treatment variables were correlated with early and late complications.Results251 patients were included; mean age was 49.7 (25 to 78) years. Reconstruction was immediate in 94% of the patients, with 88% performed with a temporary tissue expander. Postoperative radiotherapy (RT) was delivered to 167 patients (66.5%). Early complications were present in 26.3% of the patients. Irradiated patients presented 5.4% incidence of late complications versus 2.4% for non-irradiated patients (p = 0.327). Diabetes (OR = 3.41 95% CI: 1.23–9.45, p = 0.018) and high body mass index (BMI) (OR = 2.65; 95% CI: 1.60–4.37, p < 0.0001) were the main risk factors. The overall incidence of late complications was 4.4%, with predominance of severe capsular contracture (8/11). Arterial hypertension (OR = 4.78; 95% CI: 1.97–11.63, p = 0.001), BMI (OR = 0.170; 95% CI: 0.048–0.607, p = 0.006) and implant placement (OR = 3.55; 95% CI: 1.26–9.99, p = 0.016) were related to late complications.ConclusionsThe overall rate of complications was low in this population. Radiotherapy delivery translated into a higher but not statistically significant risk of late complications when compared with the non-irradiated patients. Already well-known clinical risk factors for complications after breast reconstruction were identified.
Keywords:breast neoplasm  reconstruction  alloplastic material  acute toxicities  radiotherapy  implants  tissue expander  outcome  complications
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