Breast reconstruction and radiotherapy

Зернов, Константин; Дашян, Г. А.; Krivorotko, Petr; Новиков, С. Н.; Палтуев, Р. М.; Табагуа, Тенгиз; Жильцова, Е. К.; Оперманас, Ю. А.; Емельянов, А. С.; Ерещенко, С. С.; Petrova, Atanaska; Kanaev, Sergey; Семиглазов, Владимир

doi:10.18027/2224-5057-2017-1-30-36

Cited by 4 publications

(1 citation statement)

References 2 publications

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“…Реконструкция молочной железы в сочетании с ЛТ снижает риск рецидива РМЖ, однако растет процент осложнений и в первую очередьчастота капсулярных контрактур в случае реконструкции имплантами [24].…”

Section: влияние лучевой терапии на осложнения при реконструкции моло...unclassified

Radiation Therapy for Breast Cancer pT1–3N0–1M0 after Mastectomy or Subcutaneous/Skin-Preserving Mastectomy with Reconstruction. Literature Review

Рассказова¹,

Zikiryakhodzhaev²,

Khmelevsky³

2023

MEDICAL RADIOLOGY AND RADIATION SAFETY

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Purpose: The literature review analyzes publications over the past decades on the need for radiation therapy after mastectomy or subcutaneous/skin-preserving mastectomy with reconstruction. Results: Risk factors for breast cancer recurrence were analyzed. The effect of radiation therapy on the recurrence of breast cancer after mastectomy, subcutaneous and skin-preserving mastectomy with reconstruction was evaluated depending on the stage, lymph node lesions, and the presence of unfavorable molecular biological types. Indications for radiation therapy are described. The effect of radiation therapy on early and late complications of the reconstructed breast and options for reducing the percentage of complications were analyzed. Conclusion: The exclusion of radiation therapy from the breast cancer treatment plan is a decrease in the percentage of complications caused by radiation therapy, for example, during implant reconstruction – a decrease in capsular contractures. And, as a result, improving the quality of life of patients, reducing repeated operations in case of complications, which means it is economically profitable. In recent years, due to the increasing need for various breast reconstruction options, the surgeon and radiotherapist have faced the task of choosing the optimal sequence of breast reconstruction, as well as reducing the risk of post-radiation complications. Radiation therapy, along with reducing the risk of relapse of the disease, increases the risk of complications after breast reconstruction, and vice versa, the reconstructed mammary gland can cause difficulties for the radiologist to correctly deliver the required dose of radiation. Minimizing the frequency and severity of complications after radiation therapy on the reconstructed gland without compromising oncological or cosmetic results is an important and common interdisciplinary goal for oncologists and radiotherapists.

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Section: влияние лучевой терапии на осложнения при реконструкции моло...unclassified

Radiation Therapy for Breast Cancer pT1–3N0–1M0 after Mastectomy or Subcutaneous/Skin-Preserving Mastectomy with Reconstruction. Literature Review

Рассказова¹,

Zikiryakhodzhaev²,

Khmelevsky³

2023

MEDICAL RADIOLOGY AND RADIATION SAFETY

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Utility of dual-energy contrast-enhanced spectral mammography for the diagnosis of multicentric breast cancer

Chernaya

Ulyanova

Krivorotko

et al. 2022

Opuholi ženskoj reproduktivnoj sistemy

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Background. Breast cancer (BC) can be unifocal, multifocal, multicentric (MCBC) and bilateral according to number and localization of tumors. MCBC has different clinical and biological characteristics compared to unifocal BC, for example, a higher risk of lymph node involvement, a more aggressive natural history and a worse prognosis. Therefore, accurate diagnosis and detection of MCBC is one of the main tasks of imaging.Objective: to compare diagnostic accuracy of contrast enhanced spectral mammography (CESM) and digital mammography (DM) in the diagnosis of MCBC.Materials and methods. The study included 438 women with suspected BC. The results of DM and CESM were compared with the results of a pathomorphological study performed after surgery or biopsy to assess the effectiveness of imaging modalities. DM was performed for all women using a Senographe DS (GE, USA) unit. CESM was performed after intravenous injection of non-ionic contrast agents using injector with breast compression in the craniocaudal and mediolateral projections. The study was performed for both glands regardless of the location of the suspicious lesion in order to timely diagnose clinically asymptomatic bilateral cancer. The final diagnosis was made based on the results of the pathomorphological examination. MCBC was diagnosed when two or more tumors at a distance of 3 cm or more from each other were detected. Visualization of additional grouped calcifications of malignant type occupying a small portion of breast tissue (more than 15 pieces per 1 sq. cm) was considered as another mammographic sign of MCBC.Results. According to the pathomorphological examination BC was diagnosed in 154 (35 %) women out of 438 examined patients. MCBC was identified in 25 (16 %) of 154 patients. CESM was more effective than DM in detecting MCBC with sensitivity of 88.0 % vs 48.0 % (p = 0.002), accuracy of 92.2 % vs 90.9 %, negative predictive value of 97.6 % vs 90.8 % (p = 0.02), respectively. But the specificity was significantly higher in DM than in CESM – 99.2 % vs 93.0 % (p = 0.009), respectively, and the positive predictive value did not differ significantly (p = 0.12).Conclusion. CESM is a more sensitive method for diagnosing MCBC compared to DM with sensitivity of 88.0 % vs 48.0 %. The high negative predictive value of CESM (97.6 %) confirms the fact that this modality is an effective method for planning surgery and radiation therapy.

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Radiation therapy and breast reconstruction

Иосифович

Gulian

Никифорова

et al. 2020

Tihookeanskij medicinskij žurnal

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Radiation therapy is an integral component of the treatment of breast cancer. Although its implementing after breast reconstruction sufficiently increases the number of complications, particularly capsular contractures. After having analyzed published materials and meta-analysis research the authors made a conclusion – if a patient is planned to have a breast reconstruction, it’s better to make it with her own tissue. On the other hand the risk of capsular contractures development significantly decreases when using acellular matrix and polyurethane shell to cover the implant. This fact gives hope that conflict between breast reconstruction and the necessity of the radiation therapy can be solved.

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Breast reconstruction and radiotherapy

Cited by 4 publications

References 2 publications

Radiation Therapy for Breast Cancer pT1–3N0–1M0 after Mastectomy or Subcutaneous/Skin-Preserving Mastectomy with Reconstruction. Literature Review

Radiation Therapy for Breast Cancer pT1–3N0–1M0 after Mastectomy or Subcutaneous/Skin-Preserving Mastectomy with Reconstruction. Literature Review

Utility of dual-energy contrast-enhanced spectral mammography for the diagnosis of multicentric breast cancer

Radiation therapy and breast reconstruction

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