Houston, Texas: From the Department of Plastic and Reconstructive Surgery, University of Texas M. D. Anderson Cancer Center. Steven J. Kronowitz, M.D.; Department of Plastic Surgery, University of Texas M. D. Anderson Cancer Center, Unit 1488, P. O. Box 301402, Houston, Texas 77230-1402, skronowi@mdanderson.org
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.
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.
About Me
- E. Bradley Garber MD FACS
- Tulsa, Oklahoma, United States
- I was born in New Orleans. I obtained my B.A. degree with Distinction and Phi Beta Kappa Honors from the University of Colorado. I obtained my M.D. degree from L.S.U. Medical Center. I completed a 5 year surgery residency specializing in Otolaryngology and Head and Neck Surgery in Denver Colorado. I served in the military and spent two years in Germany at Landstuhl Army Medical Center. From 1983-1985, I trained in Plastic and Reconstructive Surgery in Miami, Florida under world renowned plastic surgeon, Dr. Ralph Millard. I have been in solo practice for over 20 years performing cosmetic and reconstructive surgery. I have obtained Board Certification by two boards recognized by the American Board of Medical Specialities: The Amercian Board of Plastic Surgery and the American Board of Otolaryngology/Head & Neck Surgery. I have served as President of the Tulsa County Medical Society and Chief of Surgery at St. John Medical Center. It has been an honor and priviledge to provide surgical care to my patients. email: bradgarber@sbcglobal.net