Radiation effects on the cosmetic outcomes of immediate and delayed autologous breast reconstruction: an argument about timing.

نویسندگان

  • M Javaid
  • F Song
  • S Leinster
  • M G Dickson
  • N K James
چکیده

OBJECTIVE To conduct a systematic review to gather the available evidence on the optimum timing of the radiotherapy in relation to autologous breast reconstruction. MATERIAL AND METHODS The data was extracted from scientific databases, and a manual follow-up of references. The studies were selected which included at least 20 patients with any method of autologous breast reconstruction who were treated with adjuvant radiotherapy either before or after their reconstruction, and had addressed the effects of radiotherapy on the cosmetic outcome in their results. The principal outcome was cosmetic appearance. Secondary outcomes were immediate and delayed complications. RESULTS We could not find any randomised controlled trial on this topic. Ten studies were included, most were retrospective, heterogeneous in terms of control groups, radiation doses, follow-up duration, and outcome measurements. Two studies included no control groups, and four studies compared the outcomes of patients with radiotherapy either before (n=3) or after (n=1) autologous breast reconstruction. The overall incidence of complications was increased in patients with radiotherapy in three out of these four studies. Only four studies directly compared the outcomes of patients who received radiotherapy before with patients who received radiotherapy after autologous breast reconstruction and two out of these reported worse outcomes associated with post-reconstruction radiotherapy. CONCLUSIONS Despite the paucity of the published data, the current evidence suggests that the radiation has a deleterious effect on autologous flap reconstruction. Until better methods of radiation delivery can be devised to minimise the long term radiation sequelae in the irradiated tissue, delayed reconstruction seems to be a safe option in most of the cases. However, the findings from these studies should be interpreted with great caution before generalising from their results.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Abstract: Analysis of Clinical Outcomes, Cosmetic Results, and Patient Satisfaction Following Delayed-Immediate Breast Reconstruction

INTRODUCTION: Autologous breast reconstruction is the preferred technique for those patients who require radiation therapy as part of their treatment plan. In order to avoid the detrimental effects of radiation, these patients may benefit from immediate placement of a tissue expander at the time of mastectomy followed by a second stage conversion to autologous tissue (delayed-immediate reconstr...

متن کامل

Abstract: Delayed-Immediate vs. Immediate Free Autologous Breast Reconstruction: A Comparison of Outcomes

INTRODUCTION: Autologous breast reconstruction is the preferred technique for those patients who require radiation therapy as part of their treatment plan. In order to avoid the detrimental effects of radiation, these patients may benefit from immediate placement of a tissue expander at the time of mastectomy followed by a second stage conversion to autologous tissue (delayed-immediate reconstr...

متن کامل

Considering the Optimal Timing of Breast Reconstruction With Abdominal Flaps With Adjuvant Irradiation in 370 Consecutive Pedicled Transverse Rectus Abdominis Myocutaneous Flap and Free Deep Inferior Epigastric Perforator Flap Performed in a Chinese Oncology Center

PURPOSE There is an ongoing debate on the optimal sequence of radiation and breast reconstruction. The purpose of this article was to (a) assess the impact of radiation on autologous breast reconstruction and (b) analyze the best timing for autologous breast reconstruction in the setting of radiation in a Chinese population. METHODS A retrospective review of patients undergoing breast reconst...

متن کامل

Delayed versus Delayed-Immediate Autologous Breast Reconstruction: A Blinded Evaluation of Aesthetic Outcomes

BACKGROUND The technique of delayed-immediate breast reconstruction includes immediate insertion of a tissue expander, post-mastectomy radiation, followed by reconstruction. The aesthetic benefits of delayed-immediate reconstruction compared to delayed reconstruction are postulated but remain unproven. The purpose of this study was to compare aesthetic outcomes in patients following delayed and...

متن کامل

Patient-reported Quality of Life and Satisfaction With Cosmetic Outcomes After Breast Conservation and Mastectomy With and Without Reconstruction: Results of a Survey of Breast Cancer Survivors.

OBJECTIVE Although breast conservation is therapeutically equivalent to mastectomy for most patients with early-stage breast cancer, an increasing number of patients are pursuing mastectomy, which may be followed by breast reconstruction. We sought to evaluate long-term quality of life and cosmetic outcomes after different locoregional management approaches, as perceived by patients themselves....

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:
  • Journal of plastic, reconstructive & aesthetic surgery : JPRAS

دوره 59 1  شماره 

صفحات  -

تاریخ انتشار 2006