Immediate Breast Reconstruction Outcomes in Patients with Prior Mantle and Whole Breast Irradiation

Limited studies have detailed the risk of mastectomy with immediate breast reconstruction among women who previously received mantle field radiation. A single institution retrospective review from 2010 to 2020 of patients previously treated with mantle field radiation (MF-RT) and subsequent mastecto...

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Published in:Plastic and reconstructive surgery. Global open 2024-09, Vol.12 (9), p.e6121
Main Authors: Mullen, Barbara L, Mazroua, Muhammad S, Murphy, Brenna M, Boonipat, Thanapoom, Gao, Robert W, Mrdutt, Mary M, Shumway, Dean A, Degnim, Amy C, Vijayasekaran, Aparna
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container_issue 9
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container_title Plastic and reconstructive surgery. Global open
container_volume 12
creator Mullen, Barbara L
Mazroua, Muhammad S
Murphy, Brenna M
Boonipat, Thanapoom
Gao, Robert W
Mrdutt, Mary M
Shumway, Dean A
Degnim, Amy C
Vijayasekaran, Aparna
description Limited studies have detailed the risk of mastectomy with immediate breast reconstruction among women who previously received mantle field radiation. A single institution retrospective review from 2010 to 2020 of patients previously treated with mantle field radiation (MF-RT) and subsequent mastectomy with immediate breast reconstruction was performed. Patients with prior whole breast irradiation (WBI) were also included as a reference group. Demographic, comorbidity, and surgical factors were collected. The primary outcome was major complications, defined as those requiring reoperation, intravenous antibiotics, or debridement. Fourteen patients with prior MF-RT (27 breasts) and 129 with prior WBI (132 breasts) underwent mastectomy with immediate reconstruction. Prior MF-RT patients were significantly younger (43.8 versus 57.5,  
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A single institution retrospective review from 2010 to 2020 of patients previously treated with mantle field radiation (MF-RT) and subsequent mastectomy with immediate breast reconstruction was performed. Patients with prior whole breast irradiation (WBI) were also included as a reference group. Demographic, comorbidity, and surgical factors were collected. The primary outcome was major complications, defined as those requiring reoperation, intravenous antibiotics, or debridement. Fourteen patients with prior MF-RT (27 breasts) and 129 with prior WBI (132 breasts) underwent mastectomy with immediate reconstruction. Prior MF-RT patients were significantly younger (43.8 versus 57.5,  &lt; 0.001) and had significantly lower body mass index (23.6 versus 26.8,  = 0.004) compared with prior WBI patients. Nipple-sparing mastectomy was significantly more common in the mantle than in the WBI patients (78.6% versus 35.9%,  = 0.03). 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Prior MF-RT patients were significantly younger (43.8 versus 57.5,  &lt; 0.001) and had significantly lower body mass index (23.6 versus 26.8,  = 0.004) compared with prior WBI patients. Nipple-sparing mastectomy was significantly more common in the mantle than in the WBI patients (78.6% versus 35.9%,  = 0.03). Most (13, 92.9%) prior mantle patients underwent tissue expander/implant-based reconstruction. Three (21.4%) prior MF-RT patients had major complications at any point, but none required an alternative type of reconstruction. On multiple variable analysis, there was no significant difference in major complication risk among prior MF-RT versus WBI patients (HR 0.74, confidence interval 0.20-2.70,  = 0.74). 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title Immediate Breast Reconstruction Outcomes in Patients with Prior Mantle and Whole Breast Irradiation
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