The Effect of Adjuvant Radiotherapy on One- and Two-Stage Prosthetic Breast Reconstruction and on Autologous Reconstruction: A Multicenter Italian Study among 18 Senonetwork Breast Centres
Purpose. In modern breast cancer treatment, a growing role has been observed for breast reconstruction together with an increase in clinical indications for postmastectomy radiotherapy (PMRT). Choosing the optimum type of reconstructive technique is a clinical challenge. We therefore conducted a nat...
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2023-01-01
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Series: | The Breast Journal |
Online Access: | http://dx.doi.org/10.1155/2023/6688466 |
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author | Andrea Vittorio Emanuele Lisa Marzia Salgarello Alessandra Huscher Fabio Corsi Daniele Piovani Federica Rubbino Stefania Andreoletti Giovanni Papa Francesco Klinger Corrado Tinterri Alberto Testori Marta Scorsetti Paolo Veronesi Maria Cristina Leonardi Mario Rietjens Umberto Cortinovis Valeria Summo Emanuele Rampino Cordaro Pier Camillo Parodi Paolo Persichetti Mauro Barone Giorgio De Santis Matteo Murolo Michele Riccio Angelica Aquinati Francesco Cavaliere Nicola Vaia Giulia Pagura Erica Dalla Venezia Franco Bassetto Vincenzo Vindigni Luigi Ciuffreda Maria Alessandra Bocchiotti Alberto Sciarillo Nadia Renzi Graziano Meneghini Tajna Kraljic Andrea Loreti Lucio Fortunato Valentina Pino Valeriano Vinci Marco Klinger |
author_facet | Andrea Vittorio Emanuele Lisa Marzia Salgarello Alessandra Huscher Fabio Corsi Daniele Piovani Federica Rubbino Stefania Andreoletti Giovanni Papa Francesco Klinger Corrado Tinterri Alberto Testori Marta Scorsetti Paolo Veronesi Maria Cristina Leonardi Mario Rietjens Umberto Cortinovis Valeria Summo Emanuele Rampino Cordaro Pier Camillo Parodi Paolo Persichetti Mauro Barone Giorgio De Santis Matteo Murolo Michele Riccio Angelica Aquinati Francesco Cavaliere Nicola Vaia Giulia Pagura Erica Dalla Venezia Franco Bassetto Vincenzo Vindigni Luigi Ciuffreda Maria Alessandra Bocchiotti Alberto Sciarillo Nadia Renzi Graziano Meneghini Tajna Kraljic Andrea Loreti Lucio Fortunato Valentina Pino Valeriano Vinci Marco Klinger |
author_sort | Andrea Vittorio Emanuele Lisa |
collection | DOAJ |
description | Purpose. In modern breast cancer treatment, a growing role has been observed for breast reconstruction together with an increase in clinical indications for postmastectomy radiotherapy (PMRT). Choosing the optimum type of reconstructive technique is a clinical challenge. We therefore conducted a national multicenter study to analyze the impact of PMRT on breast reconstruction. Methods. We conducted a retrospective case-control multicenter study on women undergoing breast reconstruction. Data were collected from 18 Italian Breast Centres and stored in a cumulative database which included the following: autologous reconstruction, direct-to-implant (DTI), and tissue expander/immediate (TE/I). For all patients, we described complications and surgical endpoints to complications such as reconstruction failure, explant, change in type of reconstruction, and reintervention. Results. From 2001 to April 2020, 3116 patients were evaluated. The risk for any complication was significantly increased in patients receiving PMRT (aOR, 1.73; 95% CI, 1.33–2.24; p<0.001). PMRT was associated with a significant increase in the risk of capsular contracture in the DTI and TE/I groups (aOR, 2.24; 95% CI, 1.57–3.20; p<0.001). Comparing type of procedures, the risk of failure (aOR, 1.82; 95% CI, 1.06–3.12, p=0.030), explant (aOR, 3.34; 95% CI, 3.85–7.83, p<0.001), and severe complications (aOR, 2.54; 95% CI, 1.88–3.43, p<0.001) were significantly higher in the group undergoing DTI reconstruction as compared to TE/I reconstruction. Conclusion. Our study confirms that autologous reconstruction is the procedure least impacted by PMRT, while DTI appears to be the most impacted by PMRT, when compared with TE/I which shows a lower rate of explant and reconstruction failure. The trial is registered with NCT04783818, and the date of registration is 1 March, 2021, retrospectively registered. |
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id | doaj-art-3de9676742614c0b840b1ac1797df29a |
institution | Kabale University |
issn | 1524-4741 |
language | English |
publishDate | 2023-01-01 |
publisher | Wiley |
record_format | Article |
series | The Breast Journal |
spelling | doaj-art-3de9676742614c0b840b1ac1797df29a2025-02-03T06:42:44ZengWileyThe Breast Journal1524-47412023-01-01202310.1155/2023/6688466The Effect of Adjuvant Radiotherapy on One- and Two-Stage Prosthetic Breast Reconstruction and on Autologous Reconstruction: A Multicenter Italian Study among 18 Senonetwork Breast CentresAndrea Vittorio Emanuele Lisa0Marzia Salgarello1Alessandra Huscher2Fabio Corsi3Daniele Piovani4Federica Rubbino5Stefania Andreoletti6Giovanni Papa7Francesco Klinger8Corrado Tinterri9Alberto Testori10Marta Scorsetti11Paolo Veronesi12Maria Cristina Leonardi13Mario Rietjens14Umberto Cortinovis15Valeria Summo16Emanuele Rampino Cordaro17Pier Camillo Parodi18Paolo Persichetti19Mauro Barone20Giorgio De Santis21Matteo Murolo22Michele Riccio23Angelica Aquinati24Francesco Cavaliere25Nicola Vaia26Giulia Pagura27Erica Dalla Venezia28Franco Bassetto29Vincenzo Vindigni30Luigi Ciuffreda31Maria Alessandra Bocchiotti32Alberto Sciarillo33Nadia Renzi34Graziano Meneghini35Tajna Kraljic36Andrea Loreti37Lucio Fortunato38Valentina Pino39Valeriano Vinci40Marco Klinger41Reconstructive and Aesthetic Plastic Surgery SchoolDepartment of Plastic SurgeryDepartment of RadiotherapyBreast UnitDepartment of Biomedical SciencesLaboratory of Molecular GastroenterologyReconstructive and Aesthetic Plastic Surgery SchoolDepartment of Plastic SurgeryIRCCS MultimedicaBreast UnitBreast UnitRadiotherapy and Radiosurgery DepartmentDivision of SenologyDivision of RadiotherapyDivision of Plastic and Reconstructive SurgeryDepartment of Plastic Reconstructive SurgeryDepartment of Plastic SurgeryDepartment of Plastic SurgeryCampus BioMedicoCampus BioMedicoDepartment of Plastic SurgeryDepartment of Plastic SurgeryDepartment of Reconstructive Surgery and Hand SurgeryDepartment of Reconstructive Surgery and Hand SurgeryDepartment of Breast Surgery and Integrated Senology CentreDepartment of Breast Surgery and Integrated Senology CentreDepartment of Breast SurgeryDepartment of Breast SurgeryUnit of Plastic SurgeryUnit of Plastic SurgeryDepartment of Breast Surgery and Breast UnitDepartment of Breast Surgery and Breast UnitDepartment of Plastic SurgeryDepartment of Plastic SurgeryDepartment of Plastic SurgeryFunctional Department Transmural Breast SurgeryDepartment of Breast SurgeryDepartment of Plastic SurgeryDepartment of Breast Surgery and Breast UnitIstituto di Clinica ChirurgicaDepartment of Biomedical SciencesReconstructive and Aesthetic Plastic Surgery SchoolPurpose. In modern breast cancer treatment, a growing role has been observed for breast reconstruction together with an increase in clinical indications for postmastectomy radiotherapy (PMRT). Choosing the optimum type of reconstructive technique is a clinical challenge. We therefore conducted a national multicenter study to analyze the impact of PMRT on breast reconstruction. Methods. We conducted a retrospective case-control multicenter study on women undergoing breast reconstruction. Data were collected from 18 Italian Breast Centres and stored in a cumulative database which included the following: autologous reconstruction, direct-to-implant (DTI), and tissue expander/immediate (TE/I). For all patients, we described complications and surgical endpoints to complications such as reconstruction failure, explant, change in type of reconstruction, and reintervention. Results. From 2001 to April 2020, 3116 patients were evaluated. The risk for any complication was significantly increased in patients receiving PMRT (aOR, 1.73; 95% CI, 1.33–2.24; p<0.001). PMRT was associated with a significant increase in the risk of capsular contracture in the DTI and TE/I groups (aOR, 2.24; 95% CI, 1.57–3.20; p<0.001). Comparing type of procedures, the risk of failure (aOR, 1.82; 95% CI, 1.06–3.12, p=0.030), explant (aOR, 3.34; 95% CI, 3.85–7.83, p<0.001), and severe complications (aOR, 2.54; 95% CI, 1.88–3.43, p<0.001) were significantly higher in the group undergoing DTI reconstruction as compared to TE/I reconstruction. Conclusion. Our study confirms that autologous reconstruction is the procedure least impacted by PMRT, while DTI appears to be the most impacted by PMRT, when compared with TE/I which shows a lower rate of explant and reconstruction failure. The trial is registered with NCT04783818, and the date of registration is 1 March, 2021, retrospectively registered.http://dx.doi.org/10.1155/2023/6688466 |
spellingShingle | Andrea Vittorio Emanuele Lisa Marzia Salgarello Alessandra Huscher Fabio Corsi Daniele Piovani Federica Rubbino Stefania Andreoletti Giovanni Papa Francesco Klinger Corrado Tinterri Alberto Testori Marta Scorsetti Paolo Veronesi Maria Cristina Leonardi Mario Rietjens Umberto Cortinovis Valeria Summo Emanuele Rampino Cordaro Pier Camillo Parodi Paolo Persichetti Mauro Barone Giorgio De Santis Matteo Murolo Michele Riccio Angelica Aquinati Francesco Cavaliere Nicola Vaia Giulia Pagura Erica Dalla Venezia Franco Bassetto Vincenzo Vindigni Luigi Ciuffreda Maria Alessandra Bocchiotti Alberto Sciarillo Nadia Renzi Graziano Meneghini Tajna Kraljic Andrea Loreti Lucio Fortunato Valentina Pino Valeriano Vinci Marco Klinger The Effect of Adjuvant Radiotherapy on One- and Two-Stage Prosthetic Breast Reconstruction and on Autologous Reconstruction: A Multicenter Italian Study among 18 Senonetwork Breast Centres The Breast Journal |
title | The Effect of Adjuvant Radiotherapy on One- and Two-Stage Prosthetic Breast Reconstruction and on Autologous Reconstruction: A Multicenter Italian Study among 18 Senonetwork Breast Centres |
title_full | The Effect of Adjuvant Radiotherapy on One- and Two-Stage Prosthetic Breast Reconstruction and on Autologous Reconstruction: A Multicenter Italian Study among 18 Senonetwork Breast Centres |
title_fullStr | The Effect of Adjuvant Radiotherapy on One- and Two-Stage Prosthetic Breast Reconstruction and on Autologous Reconstruction: A Multicenter Italian Study among 18 Senonetwork Breast Centres |
title_full_unstemmed | The Effect of Adjuvant Radiotherapy on One- and Two-Stage Prosthetic Breast Reconstruction and on Autologous Reconstruction: A Multicenter Italian Study among 18 Senonetwork Breast Centres |
title_short | The Effect of Adjuvant Radiotherapy on One- and Two-Stage Prosthetic Breast Reconstruction and on Autologous Reconstruction: A Multicenter Italian Study among 18 Senonetwork Breast Centres |
title_sort | effect of adjuvant radiotherapy on one and two stage prosthetic breast reconstruction and on autologous reconstruction a multicenter italian study among 18 senonetwork breast centres |
url | http://dx.doi.org/10.1155/2023/6688466 |
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