A Systematic Review of Complications of Implant-based Breast Reconstruction with Prereconstruction and Postreconstruction Radiotherapy

Purpose To conduct a systematic review of the literature to assess outcomes data on complications associated with implant-based breast reconstruction performed before or after chest wall radiation to assist in guiding the decision-making process for reconstruction of the irradiated breast. Methods S...

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Bibliographic Details
Published in:Annals of surgical oncology 2014, Vol.21 (1), p.118-124
Main Authors: Momoh, Adeyiza O., Ahmed, Raouf, Kelley, Brian P., Aliu, Oluseyi, Kidwell, Kelley M., Kozlow, Jeffrey H., Chung, Kevin C.
Format: Article
Language:English
Subjects:
Breast Implantation - adverse effects
Breast Neoplasms - complications
Breast Neoplasms - radiotherapy
Breast Neoplasms - surgery
Female
Humans
Mammaplasty - adverse effects
Medicine
Medicine & Public Health
Oncology
Postoperative Complications
Prognosis
Reconstructive Oncology
Surgery
Surgical Oncology
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Summary:Purpose To conduct a systematic review of the literature to assess outcomes data on complications associated with implant-based breast reconstruction performed before or after chest wall radiation to assist in guiding the decision-making process for reconstruction of the irradiated breast. Methods Studies from a PubMed search that met predetermined inclusion criteria were identified and included. Complications of interest were low- and high-grade capsular contractures, minor and major complications, reconstruction failure rates, and reconstruction completion rates. Pooled complication rates were calculated. Results A total of 26 articles were included in the study after screening 1,006 publications, with 14 studies presenting data on prereconstruction radiation and 23 studies presenting data on postreconstruction radiation. Complication rates evaluated in patients exposed to radiation before or after implant reconstruction were not significantly different. Reconstruction failure rates were similar at 19 and 20 % for pre- and postreconstruction radiation patients, respectively. Completion rates were similar at 83 and 80 % for pre- and postreconstruction radiation patients, respectively. Conclusions Review of the current literature suggests similar overall success and failure rates with radiotherapy provided both before and after reconstruction. Failure rates in both groups of patients are clinically significant when considering implant reconstruction in the setting of radiation.
ISSN:1068-9265
1534-4681
DOI:10.1245/s10434-013-3284-z