Radiation and depression associated with complications of tissue expander reconstruction

被引:12
作者
Chuba, Paul J. [1 ,7 ]
Stefani, William A. [2 ]
Dul, Carrie [3 ]
Szpunar, Susan [4 ]
Falk, Jeffrey [5 ]
Wagner, Rachael [1 ]
Edhayan, Elango [6 ]
Rabbani, Anna [1 ,7 ]
Browne, Cynthia H. [1 ,7 ]
Aref, Amr [1 ,7 ]
机构
[1] St John Macomb Oakland Hosp, Webber Canc Ctr, Dept Radiat Oncol, 11800 E 12 Mile Rd, Warren, MI 48093 USA
[2] Renaissance Plast Surg, Troy, MI 48083 USA
[3] Great Lakes Canc Management, Macomb, MI 48044 USA
[4] St John Hosp & Med Ctr, Dept Grad Med Educ, Detroit, MI 48236 USA
[5] Michigan Breast Specialists, Grosse Pointe, MI 48236 USA
[6] St John Hosp & Med Ctr, Dept Surg, Detroit, MI 48236 USA
[7] St John Hosp & Med Ctr, Van Elslander Canc Ctr, Grosse Pointe, MI 48236 USA
关键词
Breast cancer; Post-mastectomy radiation; Breast reconstruction; Tissue expander; Radiation; Side effect; Bilateral mastectomy; Depression; Risk factor; BREAST-CANCER PATIENTS; HOT FLASHES; ADJUVANT RADIOTHERAPY; PREMENOPAUSAL WOMEN; THERAPY; OUTCOMES; CHEMOTHERAPY; RISK; MASTECTOMY; RATES;
D O I
10.1007/s10549-017-4277-6
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Rates of implant failure, wound healing delay, and infection are higher in patients having radiation therapy (RT) after tissue expander (TE) and permanent implant reconstruction. We investigated pretreatment risk factors for TE implant complications. 127 breast cancer patients had TE reconstruction and radiation. For 85 cases of bilateral TE reconstruction, the non-irradiated breast provided an internal control. Comparison of differences in means for continuous variables used analysis of variance, then multiple pairwise comparisons with Bonferroni correction of p value. Mean age was 53 +/- A 10.1 years with 14.6% African-American. Twelve (9.4%) were BRCA positive (9 BRCA1, 4 BRCA2, 1 Both). Complications were: Grade 0 (no complication; 43.9%), Grade 1 (tightness and/or drifting of implant or Baker Grade II capsular contracture; 30.9%), Grade 2 (infection, hypertrophic scarring, or incisional necrosis; 9.8%), Grade 3 (Baker Grade III capsular contracture, wound dehiscence, or impending exposure of implant; 5.7%), Grade 4 (implant failure, exchange of implant, or Baker Grade IV capsular contracture; 9.8%). 15.3% (19 cases) experienced Grade 3 or 4 complication and 9.8% (12 cases) had Grade 4 complication. Considering non-irradiated breasts, there were two (1.6%) Grade 3-4 complications. For BMI, there was no significant difference by category as defined by the CDC (p = 0.91). Patients with depression were more likely to experience Grade 3 or 4 complication (29.4 vs 13.2%; p = 0.01). Using multiple logistic regression to predict the probability of a Grade 3 or 4 complications in patients with depression were found to be 4.2 times more likely to have a Grade 3 or 4 complication (OR = 4.2, p = 0.03). Higher rates of TE reconstruction complications are expected in patients receiving radiotherapy. An unexpected finding was that patients reporting medical history of depression showed statistically significant increase in complication rates.
引用
收藏
页码:641 / 647
页数:7
相关论文
共 52 条
[1]   POSTMASTECTOMY CHEST WALL RADIATION TO A TEMPORARY TISSUE EXPANDER OR PERMANENT BREAST IMPLANT-IS THERE A DIFFERENCE IN COMPLICATION RATES? [J].
Anderson, Penny R. ;
Freedman, Gary ;
Nicolaou, Nicos ;
Sharma, Navesh ;
Li, Tianyu ;
Topham, Neal ;
Morrow, Monica .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2009, 74 (01) :81-85
[2]   Low complication rates are achievable after postmastectomy breast reconstruction and radiation therapy [J].
Anderson, PR ;
Hanlon, AL ;
McNeeley, SW ;
Freedman, GM .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 2004, 59 (04) :1080-1087
[3]  
Andrade C, 2014, J CLIN PSYCHIAT, V75, P957
[4]   Identification and preoperative optimization of risk factors to prevent periprosthetic joint infection [J].
Baek, Seung-Hoon .
WORLD JOURNAL OF ORTHOPEDICS, 2014, 5 (03) :362-367
[5]  
Bashnagel AM, 2012, CLIN BREAST CANCER, V22, P248
[6]   Management of Hot Flashes in Patients Who Have Breast Cancer With Venlafaxine and Clonidine: A Randomized, Double-Blind, Placebo-Controlled Trial [J].
Boekhout, Annelies H. ;
Vincent, Andrew D. ;
Dalesio, Otilia B. ;
van den Bosch, Joan ;
Foekema-Tons, Joke H. ;
Adriaansz, Sandra ;
Sprangers, Sylvia ;
Nuijen, Bastiaan ;
Beijnen, Jos H. ;
Schellens, Jan H. M. .
JOURNAL OF CLINICAL ONCOLOGY, 2011, 29 (29) :3862-3868
[7]   Breast reconstruction and post-mastectomy radiation practice [J].
Chen, Susie A. ;
Hiley, Crispin ;
Nickleach, Dana ;
Petsuksiri, Janjira ;
Andic, Fundagul ;
Riesterer, Oliver ;
Switchenko, Jeffrey M. ;
Torres, Mylin A. .
RADIATION ONCOLOGY, 2013, 8
[8]   Bilateral risk for subsequent breast cancer after lobular carcinoma-in-situ: Analysis of surveillance, epidemiology, and end results data [J].
Chuba, PJ ;
Hamm, MR ;
Yap, J ;
Severson, RK ;
Lucas, D ;
Shamsa, F ;
Aref, A .
JOURNAL OF CLINICAL ONCOLOGY, 2005, 23 (24) :5534-5541
[9]   Trends in primary surgical and radiation therapy for localized breast cancer in the Detroit Metropolitan area 1973-1992 [J].
Chuba, PJ ;
Simon, MS .
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1997, 38 (01) :103-107
[10]   Breast Reconstruction following Nipple- Sparing Mastectomy: Predictors of Complications, Reconstruction Outcomes, and 5-Year Trends [J].
Colwell, Amy S. ;
Tessler, Oren ;
Lin, Alex M. ;
Liao, Eric ;
Winograd, Jonathan ;
Cetrulo, Curtis L. ;
Tang, Rong ;
Smith, Barbara L. ;
Austen, William G. .
PLASTIC AND RECONSTRUCTIVE SURGERY, 2014, 133 (03) :496-506