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Nipple-sparing mastectomy, immediate reconstruction and radiation yield more complications, revision

Successful reconstruction was possible in patients who had or were scheduled to receive radiation therapy who also underwent nipple-sparing mastectomy and immediate breast reconstruction; however, the combination was associated with a higher incidence of complications and revision surgeries compared with patients who did not have radiation, according to researchers.

The researchers retrospectively reviewed data from 605 patients who underwent immediate breast reconstructions following nipple-sparing mastectomy, of whom, 88 were treated with radiation. Medical records were reviewed to identify complications, and only patients with at least 1 full year of follow-up data were included in the final study.

Patients who received radiation tended to have more complications (19.3%) vs. patients who did not receive radiation (12.8%), according to the researchers. Implant loss and infection rates were also higher in the radiation group compared with the non-radiation group (6.8 % vs. 1% and 6.8% vs. 2.9%, respectively).

No significant differences were found in nipple removal secondary to malposition or positive oncologic margins in patients who received radiation therapy and those who did not, according to the researchers. However, patients who received radiation had a higher incidence of secondary procedures for fat grafting and capsular contracture compared with patients who did not receive radiation.

The researchers concluded that immediate implant-based reconstruction was an acceptable surgical option in patients who already received radiation therapy or who would receive radiation therapy following nipple-sparing mastectomy. - by Abigail Sutton

Disclosures: Reish reports no relevant financial disclosures. Please see the full study for a list of all other authors' financial disclosures.