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The Impact of Radiotherapy on Reoperation Rates in Patients Undergoing Mastectomy and Breast Reconstruction

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Objective

The aim of this study was to determine the impact of postmastectomy radiotherapy (PMRT) on reoperation rates in women with breast cancer undergoing mastectomy and breast reconstruction.

Methods

Between June 2001 and December 2015, 832 breast cancer patients treated with mastectomy and breast reconstruction with (n = 159) or without (n = 673) PMRT were analyzed retrospectively. Reoperations following breast reconstruction were categorized into the following three types: anticipated, unanticipated, and others. Multivariable logistic regression models were used to evaluate the impact of PMRT on overall and unanticipated reoperations according to different breast reconstruction types after adjusting for relevant covariates.

Results

With a median follow-up of 58.5 months, a total of 1298 operations were performed in 832 breast cancer patients. The rates of overall and unanticipated reoperations were 46.2% and 7.7%, respectively. Multivariable analysis showed that PMRT was not associated with overall reoperations in either implant-based reconstruction patients (odds ratio [OR] 1.00, 95% confidence interval [CI] 0.43–2.37, p = 0.995) or autologous reconstruction patients (OR 0.85, 95% CI 0.52–1.40, p = 0.533); however, the impact of PMRT on unanticipated reoperations differed by reconstruction type. In patients who received implant-based reconstructions, PMRT was associated with a 3.05-fold (95% CI 1.20–7.75, p = 0.019) higher odds of unanticipated reoperations, while there was no difference in patients who underwent autologous reconstruction (OR 1.17, 95% CI 0.51–2.66, p = 0.713). Delayed reconstruction or delayed–immediate reconstructions were associated with an increased risk of both overall and unanticipated reoperations in both reconstruction cohorts.

Conclusions

PMRT appears to be associated with an increased risk of unanticipated reoperations among patients receiving implant-based reconstruction, but not among those receiving autologous reconstruction. The risk of reoperation should be taken into consideration when selecting the appropriate breast reconstruction type when PMRT is planned.

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Author notes

  1. Li Zhang and Kairui Jin contributed equally to this work.

Authors and Affiliations

  1. Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China

    Li Zhang MD, Kairui Jin MD, Xuanyi Wang MD, Zhaozhi Yang MD, Junqi Wang MD, Jinli Ma MD, Xin Mei MD, Xingxing Chen PhD, Xiaofang Wang PhD, Zhirui Zhou PhD, Jurui Luo PhD, Zhen Zhang MD, Xiaoli Yu MD & Xiaomao Guo MD

  2. Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, China

    Li Zhang MD, Kairui Jin MD, Xuanyi Wang MD, Zhaozhi Yang MD, Junqi Wang MD, Jinli Ma MD, Xin Mei MD, Xingxing Chen PhD, Xiaofang Wang PhD, Zhirui Zhou PhD, Jurui Luo PhD, Jiong Wu MD, Zhimin Shao MD, Zhen Zhang MD, Xiaoli Yu MD & Xiaomao Guo MD

  3. Department of Breast Surgery, Fudan University Shanghai Cancer Center, Shanghai, China

    Jinli Ma MD, Jiong Wu MD & Zhimin Shao MD

Authors
  1. Li Zhang MD
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  2. Kairui Jin MD
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  14. Zhen Zhang MD
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  15. Xiaoli Yu MD
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  16. Xiaomao Guo MD
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Corresponding authors

Correspondence to Xiaoli Yu MD or Xiaomao Guo MD.

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Zhang, L., Jin, K., Wang, X. et al. The Impact of Radiotherapy on Reoperation Rates in Patients Undergoing Mastectomy and Breast Reconstruction. Ann Surg Oncol 26, 961–968 (2019). https://doi.org/10.1245/s10434-018-07135-4

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  • DOI: https://doi.org/10.1245/s10434-018-07135-4

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