Complications and patient-reported outcomes after radiotherapy in breast cancer patients undergoing implant-based breast reconstruction: a retrospective study from a large Chinese breast disease center
Abstract Background Postmastectomy radiation therapy (PMRT) can influence the outcome of implant-based breast reconstruction (IBBR). This study aims to investigate the complications and patient-reported outcomes (PROs) following PMRT between direct-to-implant (DTI) and tissue expander-to-implant (TE...
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BMC
2024-12-01
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| Series: | World Journal of Surgical Oncology |
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| Online Access: | https://doi.org/10.1186/s12957-024-03618-9 |
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| author | Tianyi Ma Teng Ma Xiangjun Li Xinyi Sun Weihong Cao Zhaohe Niu Haibo Wang |
| author_facet | Tianyi Ma Teng Ma Xiangjun Li Xinyi Sun Weihong Cao Zhaohe Niu Haibo Wang |
| author_sort | Tianyi Ma |
| collection | DOAJ |
| description | Abstract Background Postmastectomy radiation therapy (PMRT) can influence the outcome of implant-based breast reconstruction (IBBR). This study aims to investigate the complications and patient-reported outcomes (PROs) following PMRT between direct-to-implant (DTI) and tissue expander-to-implant (TEI) reconstruction. Methods The retrospective study included breast cancer patients undergoing IBBR and PMRT. Patients were divided into a permanent implant group (PI-PMRT) and a tissue expander group (TE-PMRT). Complications, reconstruction failure, and reoperation were compared between the two groups. PROs were assessed using the BREAST-Q scale. Results A total of 203 patients were included: 99 in the PI-PMRT group and 104 in the TE-PMRT group. The incidence of severe capsular contracture was significantly higher in the PI-PMRT group compared to the TE-PMRT group (37.4% vs. 24.0%, p = 0.039). The PI-PMRT group had a significantly lower rate of reconstruction failure (9.1% vs. 19.2%, p = 0.039) and reoperation (13.1% vs. 24.0%, p = 0.046). Multivariate analysis revealed that the absence of mesh (OR = 2.177, p = 0.040) and DTI reconstruction (OR = 1.922, p = 0.046) were independent predictors of severe capsular contracture; the absence of mesh (OR = 4.699, p = 0.015) and TEI reconstruction (OR = 2.429, p = 0.043) were independent predictors of reconstruction failure. BREAST-Q scores indicated greater breast satisfaction in the PI-PMRT group (p = 0.031). Conclusions Although DTI reconstruction resulted in a higher risk of severe capsular contracture, the higher risk of reconstruction failure and reoperation in patients undergoing TEI reconstruction was even more concerning. Furthermore, patients were more likely to report greater breast satisfaction with DTI reconstruction. Therefore, DTI reconstruction may be a more appropriate option for patients anticipating PMRT. |
| format | Article |
| id | doaj-art-df7d14d9798b43f3ba3181c2f0e8930b |
| institution | DOAJ |
| issn | 1477-7819 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj-art-df7d14d9798b43f3ba3181c2f0e8930b2025-08-20T02:39:49ZengBMCWorld Journal of Surgical Oncology1477-78192024-12-0122111110.1186/s12957-024-03618-9Complications and patient-reported outcomes after radiotherapy in breast cancer patients undergoing implant-based breast reconstruction: a retrospective study from a large Chinese breast disease centerTianyi Ma0Teng Ma1Xiangjun Li2Xinyi Sun3Weihong Cao4Zhaohe Niu5Haibo Wang6Department of Breast Center, the Affiliated Hospital of Qingdao UniversityDepartment of Breast Center, the Affiliated Hospital of Qingdao UniversityDepartment of Breast Center, the Affiliated Hospital of Qingdao UniversityDepartment of Breast Center, the Affiliated Hospital of Qingdao UniversityDepartment of Breast Center, the Affiliated Hospital of Qingdao UniversityDepartment of Breast Center, the Affiliated Hospital of Qingdao UniversityDepartment of Breast Center, the Affiliated Hospital of Qingdao UniversityAbstract Background Postmastectomy radiation therapy (PMRT) can influence the outcome of implant-based breast reconstruction (IBBR). This study aims to investigate the complications and patient-reported outcomes (PROs) following PMRT between direct-to-implant (DTI) and tissue expander-to-implant (TEI) reconstruction. Methods The retrospective study included breast cancer patients undergoing IBBR and PMRT. Patients were divided into a permanent implant group (PI-PMRT) and a tissue expander group (TE-PMRT). Complications, reconstruction failure, and reoperation were compared between the two groups. PROs were assessed using the BREAST-Q scale. Results A total of 203 patients were included: 99 in the PI-PMRT group and 104 in the TE-PMRT group. The incidence of severe capsular contracture was significantly higher in the PI-PMRT group compared to the TE-PMRT group (37.4% vs. 24.0%, p = 0.039). The PI-PMRT group had a significantly lower rate of reconstruction failure (9.1% vs. 19.2%, p = 0.039) and reoperation (13.1% vs. 24.0%, p = 0.046). Multivariate analysis revealed that the absence of mesh (OR = 2.177, p = 0.040) and DTI reconstruction (OR = 1.922, p = 0.046) were independent predictors of severe capsular contracture; the absence of mesh (OR = 4.699, p = 0.015) and TEI reconstruction (OR = 2.429, p = 0.043) were independent predictors of reconstruction failure. BREAST-Q scores indicated greater breast satisfaction in the PI-PMRT group (p = 0.031). Conclusions Although DTI reconstruction resulted in a higher risk of severe capsular contracture, the higher risk of reconstruction failure and reoperation in patients undergoing TEI reconstruction was even more concerning. Furthermore, patients were more likely to report greater breast satisfaction with DTI reconstruction. Therefore, DTI reconstruction may be a more appropriate option for patients anticipating PMRT.https://doi.org/10.1186/s12957-024-03618-9Breast cancerImplant-based breast reconstructionPostmastectomy radiation therapyComplicationPatient-reported outcome |
| spellingShingle | Tianyi Ma Teng Ma Xiangjun Li Xinyi Sun Weihong Cao Zhaohe Niu Haibo Wang Complications and patient-reported outcomes after radiotherapy in breast cancer patients undergoing implant-based breast reconstruction: a retrospective study from a large Chinese breast disease center World Journal of Surgical Oncology Breast cancer Implant-based breast reconstruction Postmastectomy radiation therapy Complication Patient-reported outcome |
| title | Complications and patient-reported outcomes after radiotherapy in breast cancer patients undergoing implant-based breast reconstruction: a retrospective study from a large Chinese breast disease center |
| title_full | Complications and patient-reported outcomes after radiotherapy in breast cancer patients undergoing implant-based breast reconstruction: a retrospective study from a large Chinese breast disease center |
| title_fullStr | Complications and patient-reported outcomes after radiotherapy in breast cancer patients undergoing implant-based breast reconstruction: a retrospective study from a large Chinese breast disease center |
| title_full_unstemmed | Complications and patient-reported outcomes after radiotherapy in breast cancer patients undergoing implant-based breast reconstruction: a retrospective study from a large Chinese breast disease center |
| title_short | Complications and patient-reported outcomes after radiotherapy in breast cancer patients undergoing implant-based breast reconstruction: a retrospective study from a large Chinese breast disease center |
| title_sort | complications and patient reported outcomes after radiotherapy in breast cancer patients undergoing implant based breast reconstruction a retrospective study from a large chinese breast disease center |
| topic | Breast cancer Implant-based breast reconstruction Postmastectomy radiation therapy Complication Patient-reported outcome |
| url | https://doi.org/10.1186/s12957-024-03618-9 |
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