Current Status of Implant-Based Breast Reconstruction in Patients Receiving Postmastectomy Radiation Therapy

被引:94
作者
Kronowitz, Steven J. [1 ]
机构
[1] Univ Texas MD Anderson Canc Ctr, Dept Plast & Reconstruct Surg, Houston, TX 77230 USA
基金
美国国家卫生研究院;
关键词
RADIOTHERAPY; COMPLICATIONS; SATISFACTION; EXPANDER; OUTCOMES; TISSUE;
D O I
10.1097/PRS.0b013e318262f059
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background: Increasing numbers of patients with breast cancer are being treated with postmastectomy radiation therapy. The author reviewed the literature to determine the clinical impact of this increasing use of postmastectomy radiation therapy in patients with breast cancer who desire implant-based breast reconstruction. Methods: The author searched the MEDLINE database for articles on breast reconstruction and radiation therapy published between January of 2008 and June of 2011 and reviewed the abstracts of those articles to identify articles with information about the impact of irradiation on implant-based breast reconstruction. This subgroup of articles was reviewed in detail. Results: Two hundred eighty-five articles were identified. Nineteen articles were reviewed in detail. Eight articles provided level III evidence; one provided level I or II evidence from high-quality multicenter or single-center randomized controlled trials or prospective cohort studies. Two articles provided level IV evidence from case series and were included in the review because they offered a novel approach or perspective. The most recent studies find a significant need for unplanned or major corrective surgery in irradiated breasts reconstructed with implants. Although breast implant reconstruction in irradiated breasts is associated with high rates of complications, only a minority of patients require conversion to an autologous tissue flap. Conclusion: Although the majority of patients who undergo implant-based reconstruction and irradiation ultimately keep the implant reconstruction, patient surveys show that irradiation has a significantly negative effect on patient satisfaction. (Plast. Reconstr. Surg. 130: 513e, 2012.)
引用
收藏
页码:513E / 524E
页数:12
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