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Postmastectomy Radiation Therapy and Breast Reconstruction: An Analysis of Complications and Patient Satisfaction

Lee, Bernard T. MD*; A. Adesiyun, Tolulope BS*; Colakoglu, Salih MD*; Curtis, Michael S. MD*; Yueh, Janet H. MD*; E. Anderson, Katarina*; Tobias, Adam M. MD*; Recht, Abram MD

doi: 10.1097/SAP.0b013e3181db7585
Clinical Papers: Northeastern Society of Plastic Surgeons
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The indications for postmastectomy radiotherapy (PMRT) have expanded over the past decade. This study examines PMRT and reconstruction compared with a control group without radiotherapy. There were 919 reconstructed breasts identified (1999–2006) and separated into 3 groups: mastectomy with PMRT before reconstruction (n = 57), immediate reconstruction then PMRT (n = 59), and reconstruction without PMRT (n = 665). A validated questionnaire assessed patient satisfaction (response rate 73.7%). Overall complication rates for patients undergoing PMRT (before and after reconstruction) were higher than that of the controls (39.66% vs. 23.16%, P < 0.001). Immediate reconstruction before PMRT had increased overall and late (>90 days) complication rates, compared with controls (47.46% vs. 23.16%, P < 0.001; 33.90% vs. 15.59%, P < 0.001, respectively); however general and aesthetic satisfaction was similar. In contrast, PMRT before reconstruction has similar complication rates and general satisfaction with controls, but decreased aesthetic satisfaction (50% vs. 66.88%, P < 0.035).

From the *Division of Plastic and Reconstructive Surgery, Departments of Surgery and †Radiation Oncology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA.

Received February 23, 2010, and accepted for publication, February 28, 2010.

Supported by the Peter Jay Sharp Foundation (to B.T.L., S.C., M.S.C., M.D.N., A.M.T.) and the Doris Duke Charitable Foundation (to J.H.Y.).

None of the authors have a financial interest in any of the products, devices, or drugs mentioned in this article.

This study was approved by the Institution Review Board at the Beth Israel Deaconess Medical Center, Boston, MA.

Presented at the 26th Annual Meeting of the Northeastern Society of Plastic Surgeons, Charleston, SC, September 2009.

Reprints: Bernard T. Lee, MD, Division of Plastic and Reconstructive Surgery, Department of Surgery, Beth Israel Deaconess Medical Center, 110 Francis St, Suite 5A, Boston, MA 02215. E-mail: blee3@bidmc.harvard.edu.

© 2010 Lippincott Williams & Wilkins, Inc.