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Immediate Breast Reconstruction in Previously Irradiated Patients

  • Cicero Urban
  • Gustavo Zucca-Matthes
  • Rene Vieira
  • Mario Rietjens
  • Iris Rabinovich
Chapter

Abstract

Breast reconstruction in previously irradiated patients represents a difficult challenge to the surgeon due to the higher rates of complication and reconstruction failure that occur in this group of patients, especially with implants. Flaps remain the primary option, although for some very well-selected patients, implants can achieve satisfactory results with low rates of short- and long-term complications. The purpose of this chapter was to establish an algorithm for breast reconstruction after recurrence of breast cancer in patients previously submitted to breast-conserving surgery and exposed to irradiation.

Keywords

Oncoplastic surgery Breast reconstruction Breast cancer Breast implants Latissimus dorsi TRAM Radiation therapy 

References

  1. 1.
    Clarke M, Collins R, Darby S, Davies C, Elphinstone P, Evans V et al (2005) Effects of radiotherapy and of differences in the extent of surgery for early breast cancer on local recurrence and 15-year survival: an overview of the randomised trials. Lancet 366(9503):2087–2106CrossRefGoogle Scholar
  2. 2.
    Hubenak JR, Zhang Q, Branch CD, Kronowitz SJ (2014) Mechanisms of injury to normal tissue after radiotherapy: a review. Plast Reconstr Surg 133(1):49e–56eCrossRefGoogle Scholar
  3. 3.
    Agarwal S, Kidwell KM, Farberg A, Kozlow JH, Chung KC, Momoh AO (2015) Immediate reconstruction of the radiated breast: recent trends contrary to traditional standards. Ann Surg Oncol 22(8):2551–2559CrossRefGoogle Scholar
  4. 4.
    Kronowitz SJ (2012) Current status of implant-based breast reconstruction in patients receiving postmastectomy radiation therapy. Plast Reconstr Surg 130(4):513e–523eCrossRefGoogle Scholar
  5. 5.
    Lee KT, Mun GH (2015) Prosthetic breast reconstruction in previously irradiated breasts: a meta-analysis. J Surg Oncol 112(5):468–475CrossRefGoogle Scholar
  6. 6.
    Evans GR, Schusterman MA, Kroll SS, Miller MJ, Reece GP, Robb GL et al (1995) Reconstruction and the radiated breast: is there a role for implants? Plast Reconstr Surg 96(5):1111–1115; discussion 6–8CrossRefGoogle Scholar
  7. 7.
    Percec I, Bucky LP (2008) Successful prosthetic breast reconstruction after radiation therapy. Ann Plast Surg 60(5):527–531CrossRefGoogle Scholar
  8. 8.
    Behranwala KA, Dua RS, Ross GM, Ward A, A’Hern R, Gui GP (2006) The influence of radiotherapy on capsule formation and aesthetic outcome after immediate breast reconstruction using biodimensional anatomical expander implants. J Plast Reconstr Aesthet Surg 59(10):1043–1051CrossRefGoogle Scholar
  9. 9.
    Ascherman JA, Hanasono MM, Newman MI, Hughes DB (2006) Implant reconstruction in breast cancer patients treated with radiation therapy. Plast Reconstr Surg 117(2):359–365CrossRefGoogle Scholar
  10. 10.
    Benediktsson K, Perbeck L (2006) Capsular contracture around saline-filled and textured subcutaneously-placed implants in irradiated and non-irradiated breast cancer patients: five years of monitoring of a prospective trial. J Plast Reconstr Aesthet Surg 59(1):27–34CrossRefGoogle Scholar
  11. 11.
    Tallet AV, Salem N, Moutardier V, Ananian P, Braud AC, Zalta R et al (2003) Radiotherapy and immediate two-stage breast reconstruction with a tissue expander and implant: complications and esthetic results. Int J Radiat Oncol Biol Phys 57(1):136–142CrossRefGoogle Scholar
  12. 12.
    Urban C, Blaszkowski D, e Silva JL, Maia T, Eduardo S, Lima RR (2011) One-stage breast reconstruction with implants in previously irradiated patients. Rev Bras Mastologia 20(4):183–186Google Scholar
  13. 13.
    McCormick B, Wright J, Cordiero P (2008) Breast reconstruction combined with radiation therapy: long-term risks and factors related to decision making. Cancer J 14(4):264–268CrossRefGoogle Scholar
  14. 14.
    Cagli B, Barone M, Ippolito E, Cogliandro A, Silipigni S, Ramella S et al (2016) Ten years experience with breast reconstruction after salvage mastectomy in previously irradiated patients: analysis of outcomes, satisfaction and well-being. Eur Rev Med Pharmacol Sci 20(22):4635–4641PubMedGoogle Scholar
  15. 15.
    Momoh AO, Ahmed R, Kelley BP, Aliu O, Kidwell KM, Kozlow JH et al (2014) A systematic review of complications of implant-based breast reconstruction with prereconstruction and postreconstruction radiotherapy. Ann Surg Oncol 21(1):118–124CrossRefGoogle Scholar
  16. 16.
    Sbitany H, Serletti JM (2011) Acellular dermis-assisted prosthetic breast reconstruction: a systematic and critical review of efficacy and associated morbidity. Plast Reconstr Surg 128(6):1162–1169CrossRefGoogle Scholar
  17. 17.
    Krishnan NM, Chatterjee A, Rosenkranz KM, Powell SG, Nigriny JF, Vidal DC (2014) The cost effectiveness of acellular dermal matrix in expander-implant immediate breast reconstruction. J Plast Reconstr Aesthet Surg 67(4):468–476CrossRefGoogle Scholar
  18. 18.
    Urban C, Faccenda PH, Veloso MLCPB, de Araújo FA, Mendes E, Lima RSL (2016) Uso do pericárdio bovino na reconstrução mamária imediata com prótese definitiva em paciente previamente irradiada. Rev Bras Mastologia 26(2):83–86CrossRefGoogle Scholar
  19. 19.
    Mofid MM, Meininger MS, Lacey MS (2012) Veritas(R) bovine pericardium for immediate breast reconstruction: a xenograft alternative to acellular dermal matrix products. Eur J Plast Surg 35(10):717–722CrossRefGoogle Scholar
  20. 20.
    Schneider WJ, Hill HL Jr, Brown RG (1977) Latissimus dorsi myocutaneous flap for breast reconstruction. Br J Plast Surg 30(4):277–281CrossRefGoogle Scholar
  21. 21.
    Scheflan M, Hartrampf CR, Black PW (1982) Breast reconstruction with a transverse abdominal island flap. Plast Reconstr Surg 69(5):908–909PubMedGoogle Scholar
  22. 22.
    Williams JK, Bostwick J 3rd, Bried JT, Mackay G, Landry J, Benton J (1995) TRAM flap breast reconstruction after radiation treatment. Ann Surg 221(6):756–764; discussion 64–6CrossRefGoogle Scholar
  23. 23.
    Kroll SS, Schusterman MA, Reece GP, Miller MJ, Smith B (1994) Breast reconstruction with myocutaneous flaps in previously irradiated patients. Plast Reconstr Surg 93(3):460–469; discussion 70–1CrossRefGoogle Scholar
  24. 24.
    Schuster RH, Kuske RR, Young VL, Fineberg B (1992) Breast reconstruction in women treated with radiation therapy for breast cancer: cosmesis, complications, and tumor control. Plast Reconstr Surg 90(3):445–452; discussion 53–4CrossRefGoogle Scholar
  25. 25.
    Schuster RH (1993) Breast reconstruction in women treated with radiation therapy for breast cancer. Plast Reconstr Surg 91(5):967CrossRefGoogle Scholar
  26. 26.
    Hardwicke JT, Prinsloo DJ (2011) An analysis of 277 consecutive latissimus dorsi breast reconstructions: a focus on capsular contracture. Plast Reconstr Surg 128(1):63–70CrossRefGoogle Scholar
  27. 27.
    Garusi C, Lohsiriwat V, Brenelli F, Galimberti VE, De Lorenzi F, Rietjens M et al (2011) The value of latissimus dorsi flap with implant reconstruction for total mastectomy after conservative breast cancer surgery recurrence. Breast 20(2):141–144CrossRefGoogle Scholar
  28. 28.
    Leonardi MC, Garusi C, Santoro L, Dell’Acqua V, Rossetto F, Didier F et al (2010) Impact of medical discipline and observer gender on cosmetic outcome evaluation in breast reconstruction using transverse rectus abdominis myocutaneous (TRAM) flap and radiotherapy. J Plast Reconstr Aesthet Surg 63(12):2091–2097CrossRefGoogle Scholar
  29. 29.
    Barry M, Kell MR (2011) Radiotherapy and breast reconstruction: a meta-analysis. Breast Cancer Res Treat 127(1):15–22CrossRefGoogle Scholar
  30. 30.
    Cordeiro PG, Snell L, Heerdt A, McCarthy C (2012) Immediate tissue expander/implant breast reconstruction after salvage mastectomy for cancer recurrence following lumpectomy/irradiation. Plast Reconstr Surg 129(2):341–350CrossRefGoogle Scholar
  31. 31.
    Fischer JP, Basta MN, Shubinets V, Serletti JM, Fosnot J (2016) A systematic meta-analysis of prosthetic-based breast reconstruction in irradiated fields with or without autologous muscle flap coverage. Ann Plast Surg 77(1):129–134CrossRefGoogle Scholar
  32. 32.
    Chetta MD, Aliu O, Zhong L, Sears ED, Waljee JF, Chung KC et al (2017) Reconstruction of the irradiated breast: a national claims-based assessment of postoperative morbidity. Plast Reconstr Surg 139(4):783–792CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2019

Authors and Affiliations

  • Cicero Urban
    • 1
  • Gustavo Zucca-Matthes
    • 2
    • 3
  • Rene Vieira
    • 4
  • Mario Rietjens
    • 5
  • Iris Rabinovich
    • 6
    • 7
  1. 1.Breast UnitOur Lady of Grace Hospital and Positivo University Medical SchoolCuritibaBrazil
  2. 2.Department of Mastology and Breast ReconstructionBarretos Cancer HospitalBarretosBrazil
  3. 3.Oncoplastic Training Center, Barretos Cancer HospitalBarretosBrazil
  4. 4.Mastology and Breast ReconstructionHospital do Câncer de BarretosBarretosBrazil
  5. 5.Division of Plastic and Reconstructive SurgeryEuropean Institute of OncologyMilanItaly
  6. 6.TocogynecologyUniversidade Federal do ParanáCuritibaBrazil
  7. 7.Breast UnitOur Lady of Grace HospitalCuritibaBrazil

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