Post-mastectomy adjuvant radiotherapy for direct-to-implant and two-stage implant-based breast reconstruction: A meta-analysis

Du, Fengzhou; Liu, Runzhu; Zhang, Hailin; Xiao, Yajun; Long, Xiao

doi:10.1016/j.bjps.2022.06.063

Cited by 12 publications

(5 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Of note, PMRT with a permanent implant had a slightly higher rate of capsular contracture (Baker III or IV) than PMRT with tissue expander (21.94% vs 15.17%), but no statistical difference was observed (P = 0.55). 30 Consistent with the above result, we detected that the incidence of capsular contracture (Baker III or IV) was 20.8% (5 of 24) in PMRT with permanent implant cohort and 12.9% (4 of 31) in PMRT with tissue expander cohort in the present study. In terms of PROs, clinical evidence is still limited on the gap between radiation with tissue expanders and radiation with permanent implants.…”

Section: Discussionsupporting

confidence: 92%

“…Recently, a meta-analysis summarized the capsular contracture rates in patients who received PMRT with a permanent implant or tissue expander. Of note, PMRT with a permanent implant had a slightly higher rate of capsular contracture (Baker III or IV) than PMRT with tissue expander (21.94% vs 15.17%), but no statistical difference was observed ( P = 0.55) 30 . Consistent with the above result, we detected that the incidence of capsular contracture (Baker III or IV) was 20.8% (5 of 24) in PMRT with permanent implant cohort and 12.9% (4 of 31) in PMRT with tissue expander cohort in the present study.…”

Section: Discussionmentioning

confidence: 87%

“…Besides, they also proposed that PMRT increases the risk of other complications (relative risk [RR] = 1.67, 95% confidence interval = 1.52 to 1.85, P < 0.001). 30 Therefore, in the setting of PMRT, the optimal management of IBBR is not well defined and the final surgical decisions are frequently determined by surgeon preferences and patient values. 31,32 Subpectoral placement offers an additional layer of soft-tissue coverage and has historically been a preferred surgical procedure.…”

Section: Discussionmentioning

confidence: 99%

“…Pooled results showed that the rate of capsular contracture (Baker III or IV) was 17.01% (158 of 929) in PMRT patients compared to 3.30% (126 of 3817) in non-PMRT patients. Besides, they also proposed that PMRT increases the risk of other complications (relative risk [RR] = 1.67, 95% confidence interval = 1.52 to 1.85, P < 0.001) 30 . Therefore, in the setting of PMRT, the optimal management of IBBR is not well defined and the final surgical decisions are frequently determined by surgeon preferences and patient values 31,32 …”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Patient-Reported Outcomes and Complication Profiles of Implant-Based Breast Reconstruction in Patients With Postmastectomy Radiation Therapy

Liu,

Chen,

Chen

et al. 2024

Ann Plast Surg

View full text Add to dashboard Cite

Objective This study aims to investigate the patient-reported outcomes (PROs) and complications of distinct implant-based breast reconstruction modality for patients with postmastectomy radiation therapy (PMRT). Methods A retrospective review was conducted on breast cancer patients with stage II-III disease who performed implant-based breast reconstruction following with PMRT between September 2016 and April 2022. The patients were categorized into two matched groups: (1) patients receiving prepectoral breast reconstruction (PBR) or (2) subpectoral breast reconstruction (SBR) followed by PMRT. Following reconstruction, the patients were further compared for PMRT with the tissue expander (PMRT-TE) versus PMRT with permanent implant (PMRT-PI). PROs were measured with BREAST-Q questionnaire. Early and late complications were recorded and analyzed. Results A total of 55 eligible patients were recruited. Patients who underwent PBR reported significantly higher satisfaction with breasts scores (P = 0.003) compared with the SBR group. The PMRT-TE group had higher satisfaction with breasts (P = 0.001) but lower physical well-being (P = 0.029) scores compared with PMRT-PI group. Moreover, patients in SBR cohort had a higher risk of capsular contracture (Baker grade III or IV) (20.5% vs 6.3%) and implant dislocation (48.7% vs 12.5%) than patients in PBR cohort. Patients in PMRT-PI group had a slightly higher rate of capsular contracture (Baker grade III or IV) than PMRT-TE group (20.8% vs 12.9%). Conclusions PBR was associated with lower rates of late complications, especially for implant dislocation, and higher satisfaction with breasts scores compared to SBR. In addition, compared to PMRT-TE with PMRT-PI, patients in PMRT-TE cohort reported superior PROs of satisfaction with breasts.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Patient-Reported Outcomes and Complication Profiles of Implant-Based Breast Reconstruction in Patients With Postmastectomy Radiation Therapy

Liu,

Chen,

Chen

et al. 2024

Ann Plast Surg

View full text Add to dashboard Cite

show abstract

“…Consistent with the literature, the results obtained in this study showed that neoadjuvant and adjuvant chemotherapy has no effect on the development of complications. It has been reported that radiotherapy increases the risk of complications and capsular contracture in patients undergoing breast reconstruction with an implant (27). Although higher rates of complication development after radiation therapy were observed in the DTI group (3 [37.5%] patients), the rates of capsular contracture development were similar between the groups (2 [5.55%] patients in the DTI group; 2 [7.41%] patients in the EI group) and no effect of radiotherapy on complication development was identified.…”

Section: Discussionmentioning

confidence: 99%

Direct to Implant versus 2-Stage Expander Implant Immediate Breast Reconstruction: Comparison of Incidence and Predictors of Complications

ALTİNKAYA,

YAZAR,

KARA

et al. 2023

Acibadem Univ Saglik Bilim Derg

View full text Add to dashboard Cite

Purpose: The most important discussion about the direct-to-implant (DTI) reconstruction is the risk of ischemic problems. Therefore, there is an ongoing debate about the effectiveness and reliability of DTI reconstruction. The current study aimed to compare the outcomes of patients undergoing DTI and expander implant (EI) reconstruction and to determine the factors that may affect the occurrence of complications. Methods: Sixty patients who underwent immediate implant reconstruction over a two-year period were included in the study. Demographic characteristics, operative characteristics and postoperative complications of the patients were retrieved retrospectively from patient records. Results: Reconstruction was performed on 34 and 27 breasts in the DTI and EI groups, respectively. The mean follow-up period of the patients was 13.8 months (range 6–28 months). Although the postoperative complication rates were high in the DTI group, no statistically significant difference was found between the two groups (p = 0.585). No statistically significant difference was found between the two groups in terms of implant failure (p = 0.579). Implant volumes of patients with complications in the DTI group were significantly higher than those without complications (p = 0.049). Conclusion: While DTI was similar to EI reconstruction in terms of implant failure, overall complication rates were higher than those in EI reconstruction. The volume of the implant is a factor that affects the development of complications in DTI reconstruction. DTI reconstruction is a reliable method that can achieve similar results to EI reconstruction with fewer surgical procedures in suitably selected patients.

show abstract

Shape Memory Polyurethane Foams With Tunable Mechanical Properties and Radiation Tolerance for Breast Repair and Reconstruction

Chung,

Feng,

Jiang

et al. 2024

J Biomedical Materials Res

View full text Add to dashboard Cite

This study developed a shape memory polyurethane foam (SM‐PUF) with tunable mechanical properties and exceptional radiation tolerance for potentially implanting tissue defects after mastectomy. The PUFs were synthesized via an in situ foaming strategy using water as a foaming agent, incorporating 4,4′‐diphenylmethane diisocyanate (MDI) as the rigid segment and both polyoxytetramethylene glycol and polycaprolactone as the soft segment. The resultant PUFs possess an open‐cell structure with a pore size of 30 ~ 800 μm, which achieves a compressive stress of 0.04 MPa under 70% compression strain and a tensile elongation of 667.9%. PUFs exhibit body temperature (37°C)‐responsive softening and shape memory abilities, with recovery and fixation ratios reaching 88% and 98%, respectively. It was verified that PUFs can resist 40 Gy radiotherapy without changing their mechanical properties and biocompatibility. This study introduces an innovative approach to produce customizable foam for the reconstruction of implant prostheses for the breast.

show abstract

Post-mastectomy adjuvant radiotherapy for direct-to-implant and two-stage implant-based breast reconstruction: A meta-analysis

Cited by 12 publications

References 41 publications

Patient-Reported Outcomes and Complication Profiles of Implant-Based Breast Reconstruction in Patients With Postmastectomy Radiation Therapy

Patient-Reported Outcomes and Complication Profiles of Implant-Based Breast Reconstruction in Patients With Postmastectomy Radiation Therapy

Direct to Implant versus 2-Stage Expander Implant Immediate Breast Reconstruction: Comparison of Incidence and Predictors of Complications

Shape Memory Polyurethane Foams With Tunable Mechanical Properties and Radiation Tolerance for Breast Repair and Reconstruction

Contact Info

Product

Resources

About