The effect of radiation on complication rates and patient satisfaction in breast reconstruction using temporary tissue expanders and permanent implants

Christopher J. Anker, Richard V. Hymas, Ravinder Ahluwalia, Kristine E. Kokeny, Vilija Avizonis, Kenneth M. Boucher, Leigh A Neumayer, Jayant P. Agarwal

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

The optimal method of reconstruction following mastectomy for breast cancer patients receiving radiation therapy (RT) is controversial. This study evaluated patient satisfaction and complication rates among patients who received implant-based breast reconstruction. The specific treatment algorithm analyzed included patients receiving mastectomy and immediate temporary tissue expander (TE), followed by placement of a permanent breast implant (PI). If indicated, RT was delivered to the fully expanded TE. Records of 218 consecutive patients with 222 invasive (85%) or in situ (15%) breast lesions from the Salt Lake City region treated between 1998 and 2009 were retrospectively reviewed, 28% of whom received RT. Median RT dose was 50.4 Gy, and 41% received a scar boost at a median dose of 10 Gy. Kaplan-Meier analyses were performed to evaluate the cumulative incidence of surgical complications, including permanent PI removal. Risk factors associated with surgical events were analyzed. To evaluate cosmetic results and patient satisfaction, an anonymous survey was administered. Mean follow-up was 44 months (range 6-144). Actuarial 5-year PI removal rates for non-RT and RT patients were 4% and 22%, respectively. On multivariate analysis (MVA), the only factor associated with PI removal was RT (p = 0.009). Surveys were returned describing the outcomes of 149 breasts. For the non-RT and RT groups, those who rated their breast appearance as good or better were 63% versus 62%, respectively. Under 1/3 of each group was dissatisfied with their reconstruction. RT did not significantly affect patient satisfaction scores, but on MVA RT was the only factor associated with increased PI removal. This reconstruction technique may be considered an acceptable option even if RT is needed, but the increased complication risk with RT must be recognized.

Original languageEnglish (US)
Pages (from-to)233-240
Number of pages8
JournalBreast Journal
Volume21
Issue number3
DOIs
StatePublished - May 1 2015
Externally publishedYes

Fingerprint

Tissue Expansion Devices
Mammaplasty
Radiation Effects
Patient Satisfaction
Radiotherapy
Breast Implants
Breast
Mastectomy
Multivariate Analysis
Kaplan-Meier Estimate
Cosmetics
Cicatrix
Therapeutics

Keywords

  • breast reconstruction
  • complications
  • patient satisfaction
  • radiation

ASJC Scopus subject areas

  • Internal Medicine
  • Oncology
  • Surgery

Cite this

Anker, C. J., Hymas, R. V., Ahluwalia, R., Kokeny, K. E., Avizonis, V., Boucher, K. M., ... Agarwal, J. P. (2015). The effect of radiation on complication rates and patient satisfaction in breast reconstruction using temporary tissue expanders and permanent implants. Breast Journal, 21(3), 233-240. https://doi.org/10.1111/tbj.12395

The effect of radiation on complication rates and patient satisfaction in breast reconstruction using temporary tissue expanders and permanent implants. / Anker, Christopher J.; Hymas, Richard V.; Ahluwalia, Ravinder; Kokeny, Kristine E.; Avizonis, Vilija; Boucher, Kenneth M.; Neumayer, Leigh A; Agarwal, Jayant P.

In: Breast Journal, Vol. 21, No. 3, 01.05.2015, p. 233-240.

Research output: Contribution to journalArticle

Anker, Christopher J. ; Hymas, Richard V. ; Ahluwalia, Ravinder ; Kokeny, Kristine E. ; Avizonis, Vilija ; Boucher, Kenneth M. ; Neumayer, Leigh A ; Agarwal, Jayant P. / The effect of radiation on complication rates and patient satisfaction in breast reconstruction using temporary tissue expanders and permanent implants. In: Breast Journal. 2015 ; Vol. 21, No. 3. pp. 233-240.
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