Effect of radiotherapy on expanders and permanent implants in immediate breast reconstruction: long-term surgical and patient-reported outcomes in a large multicentre cohort

• Published in: British journal of surgery 2021-12, Vol.108 (12), p.1474-1482
• Main Authors: Coudé Adam, Hannah, Frisell, Axel, Liu, Yihang, Sackey, Helena, Oikonomou, Ira, Docherty Skogh, Ann-Charlot, Frisell, Jan, de Boniface, Jana
• Format: Article
• Language: English
• Subjects: Adult; Aged; Breast Implants; Breast Neoplasms - therapy; Cohort Studies; Device Removal; Humans; Longitudinal Studies; Mammaplasty; Medicin och hälsovetenskap; Middle Aged; Patient Preference; Patient Reported Outcome Measures; Radiotherapy, Adjuvant; Tissue Expansion Devices
• ISSN: 1365-2168; 0007-1323; 1365-2168
• DOI: 10.1093/bjs/znab333

Current evidence for the effects of radiotherapy (RT) on implant-based immediate breast reconstruction (IBR) is limited by short follow-up and lack of patient-reported outcomes (PROs). It is central to integrate long-term comprehensive outcome data into the preoperative decision-making process. The aim of the present study was to determine long-term surgical outcomes and PROs in relation to RT after implant-based IBR. This was a longitudinal cohort study of PRO data obtained in surveys conducted in 2012 and 2020 using the BREAST-Q questionnaire. All women undergoing therapeutic mastectomy and implant-based IBR between 1 January 2007 and 31 December 2011 at four breast centres in Stockholm, Sweden, were identified. The endpoint was implant removal owing to surgical complications or patient preference. Median follow-up was 120 (range 1-171) months. After 754 IBRs in 729 women, implant removal occurred in 128 (17 per cent): 34 of 386 (8.8 per cent) in the no-RT group, 20 of 64 (31.3 per cent) in the group with previous RT, and 74 of 304 (24.3 per cent) in the postoperative RT group (P