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Old 05-24-2011, 12:12 PM   #1
Hopeful
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Join Date: Aug 2006
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Sequencing of Postmastectomy Radiotherapy & Breast Reconstruction & Rate of Complicat

Int J Radiat Oncol Biol Phys. 2011 Jun 1;80(2):392-397, TA Adesiyun, BT Lee, JH Yueh, C Chen, S Colakoglu, KEM Anderson, M-DT Nguyen, A Recht

This study looked at the sequencing of postmastectomy radiotherapy and breast reconstruction and its impact on the time to development of complications. Findings outlined in the article may prove useful for patient counseling concerning breast reconstruction.

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This study looked at the sequencing of postmastectomy radiotherapy and breast reconstruction and its impact on the time to development of complications. Findings outlined in the article may prove useful for patient counseling concerning breast reconstruction.

Abstract

Purpose: There are few long-term studies of how the sequencing of postmastectomy radiotherapy (PMRT) and breast reconstruction (BR) affects the time to development of complications or patient satisfaction with BR. We therefore studied this issue.

Methods and Materials: One hundred thirteen women who underwent BR at Beth Israel Deaconess Medical Center (Boston, MA) from 1999–2006 and also received PMRT were included. Complications requiring surgery were categorized as early (within 90 days of BR) or late. The median length of follow-up after BR was 46.5 months. Patients' general and esthetic satisfaction was assessed with a validated questionnaire.

Results: Complications occurred among 32% of 57 women receiving PMRT before BR and 44% of 57 patients having BR before PMRT (p = 0.176). Early complications were more frequent in patients who had PMRT first (18%) than for those with BR first (11%) (p = 0.210); conversely, late complication rates in the two groups were 14% and 33%, respectively (p = 0.009). General satisfaction was comparable between the PMRT-first and BR-first groups (68% and 68%, respectively; p = 0.995); esthetic satisfaction rates were also similar (50% and 62%, respectively; p = 0.238).

Conclusions: The sequencing of PMRT and BR did not have a substantial impact on the total risk of complications or patients' general and esthetic satisfaction. However, early complications tended to develop in patients having PMRT first, whereas patients having BR first had a higher risk of late complications. Additional study of the effects of sequencing of PMRT on particular types of reconstructions may help devise strategies for reducing these risks.

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