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Postmastectomy radiation treatment outcomes similar before, after expander-implant exchange

There was no significant difference in the incidence of postoperative complications between patients undergoing postmastectomy radiation treatment after or before expander-implant exchange in two-stage breast reconstruction, according to study data published in Plastic and Reconstruction Surgery.

According to Katherine B. Santosa, MD, and colleagues, the adverse effects of radiation therapy were well-known, but it is unclear how timing of postmastectomy radiation treatment (PMRT) affected postoperative complication rates.

Santosa and colleagues evaluated 150 patients recruited into the Mastectomy Reconstruction Outcomes Consortium Study who had undergone immediate two-stage implant-based breast reconstruction and received PMRT. They were separated into two cohorts.

The first cohort, TE-XRT, included 104 women who received radiation therapy after tissue expander placement but before implant exchange. The second, Implant-XRT, included 46 women undergoing radiation therapy following expander-implant exchange.

Overall, 28.7% of patients experienced a complication, the most common being surgical-site infection, either major or minor, in 22 patients (14.7%). Reconstructive failure occurred in 16 women (10.7%).

There were no significant differences in the incidence of any type of complication between the cohorts. However, the odds of complications were significantly higher in patients of increased age (OR = 1.046; 95% CI, 1.003-1.091; P = .0367) and in current or former smokers (OR=3.677; 95% CI, 1.205-11.22; P = .023).

“Although timing of PMRT did not affect the development of complications in this study, our findings highlight the importance of counseling patients preoperatively about potential outcomes following reconstruction and PMRT. Our results reinforce the notion that complications are not unusual following breast reconstruction,” the authors concluded. – by Talitha Bennett

Disclosure: The authors report no relevant financial disclosures.