Outcomes of Breast Reconstruction in Breast Cancer Patients With a History of Mantle Radiation for Hodgkin Lymphoma

Wong, Ryan; Morrison, Shane D.; Momeni, Arash; Nykiel, Matthew; Lee, Gordon K.

doi:10.1097/sap.0000000000000167

Cited by 14 publications

(7 citation statements)

References 23 publications

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“…These factors were determined a priori based on literature review and surgeon experience and included age older than 65 years, body mass index greater than 30, active smoking, history of preoperative radiation therapy, mastectomy weight greater than 800 g, Wise-pattern incision, nipple-sparing mastectomy, and direct-to-implant reconstruction. [5][6][7][8][9][10][11][12][13] We also performed an exploratory analysis of whether the effect of nitroglycerin varied according to the number of risk factors. A score of 1 was given for each of the aforementioned risk factors.…”

Section: Discussionmentioning

confidence: 99%

Effects of Nitroglycerin Ointment on Mastectomy Flap Necrosis in Immediate Breast Reconstruction

Gdalevitch

Laeken

Bahng

et al. 2015

Plastic and Reconstructive Surgery

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Section: Discussionmentioning

confidence: 99%

Effects of Nitroglycerin Ointment on Mastectomy Flap Necrosis in Immediate Breast Reconstruction

Gdalevitch

Laeken

Bahng

et al. 2015

Plastic and Reconstructive Surgery

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“…Only four studies on BR after chest radiotherapy for HL have been published previously, all of which lacked a comparison group of nonirradiated patients 27 – 30 . Bacilious et al 28 were the first to publish a series of seven patients who underwent eleven immediate tissue expander/implant BRs after MFRT for HL; they reported only one complication (9%) and no BR failure after a mean follow-up of 3 years Wong et al .…”

Section: Discussionmentioning

confidence: 99%

“…Second, the target area for MFRT does not focus on the breast and the central part of the breast is typically positioned under lung shielding blocks. Studies on the effects of previous radiotherapy for HL on the outcomes of BR are scarce, have small sample sizes, lack appropriate control groups, and show conflicting results 27 – 30 . Therefore, the aim of the present study was to compare outcomes after BR in patients with previous chest radiotherapy for HL to matched controls without HL.…”

Section: Introductionmentioning

confidence: 99%

Surgical outcomes following breast reconstruction in patients with and without a history of chest radiotherapy for Hodgkin lymphoma: a multicentre, matched cohort study

Harmeling

Woerdeman

Ozdemir

et al. 2023

International Journal of Surgery

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Background: Breast cancer is the most common treatment-related second malignancy among women with previous chest radiotherapy for Hodgkin lymphoma (HL). Little is known about the effects of this kind of radiotherapy on the outcomes of postmastectomy breast reconstruction (BR). This study compared adverse outcomes of BR after HL-related chest radiotherapy to matched controls. Methods: The authors conducted a retrospective, matched cohort study in two expert cancer centres in the Netherlands. BRs after therapeutic or prophylactic mastectomy in HL survivors who received chest radiotherapy were matched with BRs in nonirradiated patients without HL on age at mastectomy date, date of BR, and type of BR. The primary outcome was complication-related BR failure or conversion and secondary outcomes were complication-related re-operation, capsular contracture, major donor-site complications, and complication-related ICU admission. The authors analyzed all outcomes univariably using Fisher’s exact tests and the authors assessed reconstruction failure, complication-related re-operation, and capsular contracture with multivariable Cox regression analysis adjusting for confounding and data clustering. Results: Seventy BRs in 41 patients who received chest radiotherapy for HL were matched to 121 BRs in 110 nonirradiated patients. Reconstruction failure did not differ between HL survivors (12.9%) and controls (12.4%). The comparison groups showed no differences in number of reoperations, major donor-site complications, or capsular contractures. BR in HL survivors more often let to ICU admission due to complications compared with controls (P=0.048). Conclusions: We observed no increased risk of adverse outcomes following BR after previous chest radiotherapy for HL. This is important information for counselling these patients and may improve shared decision-making.

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“…However, even after radical mastectomy, the patient can benefit from adjuvant radiotherapy to the chest wall and lymph node regions to increase loco-regional control of the disease. In patients that choose to have breast reconstruction surgery, this may be particularly problematic considering the rate of postoperative complications of up to 69% 19 .…”

Section: Discussionmentioning

confidence: 99%

Reirradiação em paciente com cancro da mama tratada por linfoma de Hodgkin

Figueiredo

Delgado

Mendonça

et al. 2021

Rev. Med. (São Paulo)

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A sobrevida longa das pacientes com linfoma de Hodgkin submetidas a quimioradioterapia numa idade precoce tem evidenciado os efeitos tardios deste tratamento. O desenvolvimento de cancro da mama radio-induzido é um dos riscos descritos, ocorrendo quase exclusivamente após um intervalo de 10 anos do tratamento. A idade ao diagnóstico entre os 10-16 anos, a radioterapia de campo amplo e um aumento da dose prescrita são os fatores de risco estabelecidos. A cirurgia conservadora da mama com radioterapia adjuvante é exequível, mas, dada a irradiação prévia, devem ser equacionadas estratégias de redução de dose nos órgãos de risco. Apresenta-se o caso de cancro da mama secundário numa paciente submetida em jovem a quimioradioterapia, com técnica de irradiação em manto, por linfoma de Hodgkin supradiafragmático. Após discussão multidisciplinar e dada a vontade da paciente em preservar a mama, foi tratada com cirurgia conservadora e radioterapia adjuvante.

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Outcomes of Breast Reconstruction in Breast Cancer Patients With a History of Mantle Radiation for Hodgkin Lymphoma

Abstract: Although the risk of complications associated with preoperative radiation is well documented, physicians and patients should be cognizant of the increased risk of complications after mantle radiation as it represents a unique modality of radiation exposure.

Cited by 14 publications

References 23 publications

Effects of Nitroglycerin Ointment on Mastectomy Flap Necrosis in Immediate Breast Reconstruction

Effects of Nitroglycerin Ointment on Mastectomy Flap Necrosis in Immediate Breast Reconstruction

Surgical outcomes following breast reconstruction in patients with and without a history of chest radiotherapy for Hodgkin lymphoma: a multicentre, matched cohort study

Reirradiação em paciente com cancro da mama tratada por linfoma de Hodgkin

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