2913 - The Association between Post-Mastectomy Radiotherapy and Complications in Patients Undergoing Immediate Breast Reconstruction
Presenter(s)
B. A. Alsaati1, N. Trabulsi2, H. Aljaaly2, A. Abusanad2, N. Almalki3, and R. Ujaimi4; 1King Abdullah Medical City, Jeddah, Saudi Arabia, 2King Abdulaziz University, jeddah, Saudi Arabia, 3National Guard Hospital, jeddah, Saudi Arabia, 4Department of Radiology , Faculty of Medicine , King Abdulaziz University, Jeddah, Saudi Arabia
Purpose/Objective(s): Post-mastectomy radiation therapy (PMRT) is a critical component of breast cancer treatment, reducing locoregional recurrence, improving disease-free survival, enhancing cosmetic outcomes and quality of life. However, its integration with immediate implant-based breast reconstruction (IBBR) presents clinical challenges due to the potential for increased complications, such as capsular contracture, implant failure, and wound healing issues. Furthermore, the timing of radiation relative to reconstruction may influence outcomes. This study aims to assess the impact of PMRT on postoperative complications in IBBR patients, with a specific focus on the role of radiation timing and dose in determining surgical success and complication rates.
Materials/Methods: This retrospective study was conducted at our institution. Data from 156 patients who underwent IBBR were analyzed, including age, surgical details, pathological features, recurrence rates, and complications. PMRT regimens and treatment timing were assessed. Statistical analysis was performed using statistical software, with chi-squared and Mann-Whitney tests used to identify significant associations (p<0.05).
Results: Among the 156 patients, the mean age at diagnosis was 44.62 ± 9.59 years, with a mean BMI of 29.54 ± 7.04 kg/m². Of the participants, 60.9% received PMRT, while 39.1% did not. The overall complication rate was 53.8%, with capsular contracture significantly more common in PMRT recipients (16.8% vs. 4.9%, p<0.05). Although PMRT patients had higher rates of implant explantation surgery, delayed healing, and seroma, these differences were not statistically significant. The duration between surgery and PMRT was significantly shorter in patients who developed capsular contracture (67.18 ± 42.89 days vs. 116.16 ± 90.28 days, p<0.05). Hypo-fractionated radiation, compared to normal fractionation, did not significantly impact overall complication rates.
Conclusion: PMRT in patients undergoing IBBR is associated with an increased risk of capsular contracture, particularly when administered soon after surgery. However, overall complication rates were statistically not significant between PMRT and non-PMRT groups. Further prospective studies are needed to optimize treatment timing and minimize adverse outcomes.