National Breast Reconstruction Utilization in the Setting of Postmastectomy Radiotherapy. Academic Article uri icon

Overview

abstract

  • BackgroundImmediate breast reconstruction (IBR) is often deferred, when postmastectomy radiotherapy (PMRT) is anticipated, due to high complication rates. Nonetheless, because of robust data supporting improved health-related quality of life associated with reconstruction, physicians and patients may be more accepting of tradeoffs. The current study explores national trends of IBR utilization rates and methods in the setting of PMRT, using the National Cancer Database (NCDB). The study hypothesis is that prosthetic techniques have become the most common method of IBR in the setting of PMRT. MethodsNCDB was queried from 2004 to 2013 for women, who underwent mastectomy with or without IBR. Patients were grouped according to PMRT status. Multivariate logistic regression was used to calculate odds of IBR in the setting of PMRT. Trend analyses were done for rates and methods of IBR using Poisson regression to determine incidence rate ratios (IRRs). ResultsIn multivariate analysis, radiated patients were 30% less likely to receive IBR (p < 0.05). The rate increase in IBR was greater in radiated compared with nonradiated patients (IRR: 1.12 vs. 1.09). Rates of reconstruction increased more so in radiated compared with nonradiated patients for both implants (IRR 1.15 vs. 1.11) and autologous techniques (IRR 1.08 vs. 1.06). Autologous reconstructions were more common in those receiving PMRT until 2005 (p < 0.05), with no predominant technique thereafter. ConclusionAlthough IBR remains a relative contraindication, rates of IBR are increasing to a greater extent in patients receiving PMRT. Implants have surpassed autologous techniques as the most commonly used method of breast reconstruction in this setting.

publication date

  • February 24, 2017

Research

keywords

  • Breast Implants
  • Breast Neoplasms
  • Mammaplasty
  • Radiotherapy, Adjuvant

Identity

PubMed Central ID

  • PMC5885287

Scopus Document Identifier

  • 85013964895

Digital Object Identifier (DOI)

  • 10.1055/s-0037-1598201

PubMed ID

  • 28235218

Additional Document Info

volume

  • 33

issue

  • 5