Radioterapia e reconstrução mamária após cirurgia para tratamento do câncer de mama

Marta, Gustavo Nader; Hanna, Samir Abdallah; Martella, Eduardo; Silva, João Luís Fernandes da

doi:10.1590/s0104-42302011000200006

Cited by 2 publications

(3 citation statements)

References 4 publications

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“…To date, no consensus has been reached on the ideal sur gical time at which breast reconstruction should be performed, especially considering the multimodal context of oncologic treatment, and particularly when radiation therapy is indicated after mastectomy 1 .…”

Section: Discussionmentioning

confidence: 99%

“…Some authors recommend late reconstruction after radio therapy, suggesting that non-breast bed tissues (muscle flaps, skin, and prostheses) would be irradiated unnecessarily, presumably causing further damage to the reconstructed breast 1 . On the contrary, other scientists support the approach of immediate reconstruction based on the fact that the local tissues and lymphatic drainage would be compromised after radiotherapy -an effect that hampers the flap construction and raises the rates of postoperative complications 1,6 .…”

Section: Discussionmentioning

confidence: 99%

“…These procedures have been shown to improve the quality of life of these patients 2,3 . However, a subgroup of mastectomized patients requires adjuvant radiotherapy after reconstructive surgery to ensure locoregional control of neoplasms 1,3 . Although radiation negatively affects breast reconstruction performed with implants, the effect of radiotherapy on the autologous tissue remains uncertain 1,[3][4][5] .…”

Section: Introductionmentioning

confidence: 99%

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Impacto da radioterapia adjuvante no resultado cosmético da reconstrução mamária imediata com retalho TRAM

Pessoa¹,

Matos²,

Dias³

et al. 2012

Rev. Bras. Cir. Plást.

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Impact of adjuvant radiotherapy on the cosmetic outcome of immediate breast reconstruction performed using a transverse rectus abdominis myocutaneous flap Impact of adjuvant radiotherapy on the cosmetic outcome of immediate breast reconstruction performed using a transverse rectus abdominis myocutaneous flap Impacto da radioterapia adjuvante no resultado cosmético da reconstrução mamária imediata com retalho TRAM ABSTRACT Background: The outcome of adjuvant radiotherapy performed after breast reconstruction using autologous flaps is controversial. In this study, we aimed to assess whether postoperative radiotherapy would induce volumetric and cosmetic changes after immediate breast reconstruction performed using a transverse rectus abdominis myocutaneous (TRAM) flap. Methods: We evaluated 25 patients who were previously diagnosed with breast cancer and underwent post-mastectomy autologous reconstruction with a pedicled TRAM flap follo wed by adjuvant radiotherapy. Late aesthetic results were recorded starting 6 months after the completion of a full course of radiotherapy. Results: The average patient age was 42.2 years (range, 30-53 years). Two (8%) complete flap losses occurred due to massive fat necrosis. Two (8%) patients exhibited flap contracture and volume loss, whereas skin changes were observed in 52% of patients. Most of the patients (84%), however, had no sig nificant initial flap volume loss, contour distortion, or flap contraction. Conclusions: The cosmetic result obtained in the present study by immediate breast reconstruction performed using an irradiated TRAM flap was satisfactory compared to the data described in the literature. These findings suggest that the flap contours may be distorted by contraction and that significant volume losses can be observed in patients who may be candidates for TRAM flap reconstruction and require post-mastectomy adjuvant radiotherapy. Thus, in these circumstances, late complications due to postoperative irradiation should be considered.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Impacto da radioterapia adjuvante no resultado cosmético da reconstrução mamária imediata com retalho TRAM

Pessoa¹,

Matos²,

Dias³

et al. 2012

Rev. Bras. Cir. Plást.

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Eficácia dos exercícios com bola suíça aplicados previamente à radioterapia para câncer mama

et al. 2015

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Objetivo. Verificar a eficácia dos exercícios com bola suíça aplicados previamente à radioterapia para câncer de mama. Método. Estudo clínico, randomizado, controlado, paralelo e cego. Participaram 13 mulheres com idade de 45 a 67 anos que fizeram a primeira cirurgia por carcinoma invasivo de mama unilateral e as que tinham indicação para o tratamento radioterápico. Foram divididas em dois grupos: controle, que recebeu apenas um folheto explicativo sobre a radioterapia (GC=7) e tratado, que recebeu um folheto explicativo sobre a radioterapia mais tratamento com exercícios na bola suíça (GT=6). Foram avaliadas pelos questionários, FACT-B, escala DASH e o Inventário de Depressão de Beck. Os pacientes receberam 20 sessões de fisioterapia no qual foram realizados exercícios ativos livres para membros superiores utilizando a bola suíça, previamente a radioterapia, por 30 minutos. A análise estatística foi realizada por meio de Teste t pareado e não pareado. Resultados. Houve diferença no BDI na comparação intragrupos (p=0,02) e intergrupo GT (p=0,01), no FACT-B, no intergrupo GT (p=0,05). Na DASH ambos os grupos tiveram melhora quantitativa no final da avaliação, embora não significativa. Conclusão. Concluiu-se que a realização de exercícios com bola suíça previamente a radioterapia promoveu benefícios psicológicos e na qualidade de vida.

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Radioterapia e reconstrução mamária após cirurgia para tratamento do câncer de mama

Cited by 2 publications

References 4 publications

Impacto da radioterapia adjuvante no resultado cosmético da reconstrução mamária imediata com retalho TRAM

Impacto da radioterapia adjuvante no resultado cosmético da reconstrução mamária imediata com retalho TRAM

Eficácia dos exercícios com bola suíça aplicados previamente à radioterapia para câncer mama

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