Muscle-Sparing TRAM Flap Does Not Protect Breast Reconstruction from Postmastectomy Radiation Damage Compared with the DIEP Flap

Garvey, Patrick B.

doi:10.1007/978-3-319-18726-6_112

Cited by 16 publications

(25 citation statements)

References 52 publications

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“…Thirty-five articles included complications and/or reconstruction failures in device-based reconstructions [4][5][6]10,11,. Twenty-seven articles included complications or reconstructive failures in autologous reconstructions [4,5,9,12,[15][16][17][18][19]28,39,40,[50][51][52][53][54][55][56][57][58][59][60][61][62][63][64]. A detailed analysis of complications is depicted by method of reconstruction in Table III. A comparison of complications between device-based and autologous reconstructions in the setting of PMRT demonstrated that device-based reconstruction had a significantly higher incidence of infection (13.5% vs. 5.8%; P < 0.0001), mastectomy flap necrosis (10.5% vs. 5.0%; P ¼ 0.03), re-operation due to complication (37.0% vs. 16.6%; P ¼ <0.0001), and total complications (41.3% vs. 30.9%; P < 0.0001).…”

Section: Journal Of Surgical Oncologymentioning

confidence: 99%

Breast reconstruction and adjuvant therapy: A systematic review of surgical outcomes

El‐Sabawi

Sosin

Carey

et al. 2015

Journal of Surgical Oncology

107

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Section: Journal Of Surgical Oncologymentioning

confidence: 99%

Breast reconstruction and adjuvant therapy: A systematic review of surgical outcomes

El‐Sabawi

Sosin

Carey

et al. 2015

Journal of Surgical Oncology

107

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“…Fourteen recent studies evaluating radiation-associated complications of autologous reconstruction are included in this review, with 12 providing level III evidence and the remaining 2 providing level IV evidence (Table II). Of these, 9 reported complications following immediate reconstruction and post-operative PMRT [11,25,45,[47][48][49][50][51][52]. In these studies, a wide variation was observed in reported rates of volume loss or shrinkage that ranged from 6% to 87.5%, and incidences of contracture or contour deformities ranged from 12.6% to 75%.…”

Section: Surgical Outcomesmentioning

confidence: 99%

Radiation and breast reconstruction: Algorithmic approach and evidence-based outcomes

et al. 2016

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Postmastectomy radiation (PMRT) in the setting of immediate breast reconstruction has been associated with increased complications and poorer aesthetic outcomes for both autologous and implant reconstructions. Many centers have attempted to mitigate the deleterious effects associated with radiation by implementing an algorithmic approach to breast reconstruction. Although the literature regarding the optimal timing of radiotherapy and breast reconstruction remains controversial, reported outcomes following various algorithms have been encouraging and warrant further consideration. J. Surg. Oncol. 2016;113:906-912. © 2016 Wiley Periodicals, Inc.

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“…19,40,41 Existing data on autologous reconstruction and PMRT found an increased odds of fat necrosis and volume loss, but acceptable results with regard to complications. 21,[41][42][43][44][45] In patients who elect to undergo immediate breast reconstruction, the potential need for PMRT should be determined before surgery to diminish the risks of unexpected indication for PMRT and preserve patient satisfaction. Clinical decision-making regarding the need for PMRT and immediate breast reconstruction requires a multidisciplinary approach and careful patient counseling.…”

Section: Discussionmentioning

confidence: 99%

Risk of positive sentinel lymph node after neoadjuvant systemic therapy in clinically node negative breast cancer -implications for postmastectomy radiation therapy and immediate breast reconstruction

Samiei

Kaathoven

Boersma

et al. 2020

European Journal of Surgical Oncology

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Background. Residual axillary lymph node involvement after neoadjuvant systemic therapy (NST) is the determining factor for postmastectomy radiation therapy (PMRT). Preoperative identification of patients needing PMRT is essential to enable shared decision-making when choosing the optimal timing of breast reconstruction. We determined the risk of positive sentinel lymph node (SLN) after NST in clinically node-negative (cN0) breast cancer. Methods. All cT1-3N0 patients treated with NST followed by mastectomy and SLNB between 2010 and 2016 were identified from the Netherlands Cancer Registry. Rate of positive SLN for different breast cancer subtypes was determined. Logistic regression analysis was performed to determine correlated clinicopathological variables with positive SLN. Results. In total 788 patients were included, of whom 25.0% (197/788) had positive SLN. cT1-3N0 ER?HER2?, cT1-3N0 ER-HER2? , and cT1-2N0 triplenegative patients had the lowest rate of positive SLN: 7.2-11.5%, 0-6.3%, and 2.9-6.2%, respectively. cT1-3N0 ER?HER2-and cT3N0 triple-negative patients had the highest rate of positive SLN: 23.8-41.7% and 30.4%, respectively. Multivariable regression analysis showed that cT2 (odds ratio [OR] 1.93; 95% confidence interval [CI] 1.01-3.96), cT3 (OR 2.56; 95% CI 1.30-5.38), grade 3 (OR 0.44; 95% CI 0.21-0.91), and ER?HER2-subtype (OR 3.94; 95% CI 1.77-8.74) were correlated with positive SLN. Conclusions. In cT1-3N0 ER?HER2?, cT1-3N0 ER-HER2?, and cT1-2N0 triple-negative patients treated with NST, immediate reconstruction can be considered an acceptable option due to low risk of positive SLN. In cT1-3N0 ER?HER2-and cT3N0 triple-negative patients treated with NST, risks and benefits of immediate reconstruction should be discussed with patients due to the relatively high risk of positive SLN.

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Muscle-Sparing TRAM Flap Does Not Protect Breast Reconstruction from Postmastectomy Radiation Damage Compared with the DIEP Flap

Cited by 16 publications

References 52 publications

Breast reconstruction and adjuvant therapy: A systematic review of surgical outcomes

Breast reconstruction and adjuvant therapy: A systematic review of surgical outcomes

Radiation and breast reconstruction: Algorithmic approach and evidence-based outcomes

Risk of positive sentinel lymph node after neoadjuvant systemic therapy in clinically node negative breast cancer -implications for postmastectomy radiation therapy and immediate breast reconstruction

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