Radiotherapy Increases Complications in Reconstructed Breasts

Researchers at the University of Michigan conducted a prospective, multicenter cohort study in which they collected medical data and patient-reported outcomes data from 553 RT patients and 1,461 patients who did not receive RT. About 38% and 25 % of the patients who did and did not receive RT, respectively, received autologous reconstruction, with the rest receiving implant reconstruction. Main outcomes and measures were complications following breast reconstruction, and satisfaction based on the BREAST-Q patient-reported outcome instrument.

The results showed that after one year of follow-up, 28.8% of those receiving RT and 22.3% of those who did not had at least one complication. After two years of follow-up, 34.1% of the patients who received RT and 22.5% of those who did not experienced reconstruction-related complications. Upon analysis, RT was associated with more than double the odds of developing complications in patients who received implants, but was not associated with complications in those who received autologous reconstruction.

In addition, based on BREAST-Q scores, patient-reported satisfaction was significantly lower in those who received RT versus those who did not receive RT among patients who received implants, but no such differences were found among the patients who received autologous reconstruction. The researchers cautioned, however, that a limitation of the study is that it is observational, and does not establish cause-effect relationship. The study was presented at the San Antonio Breast Cancer Symposium, held during December 2016.

“Because many women who undergo mastectomy become long-term survivors, breast reconstruction can have a lasting impact on quality of life,” said lead author and study presenter Professor Reshma Jagsi, MD, PhD, of the department of radiation oncology. “Those who plan to pursue autologous reconstruction and are debating whether or not to receive radiotherapy may derive some reassurance from the current study findings that outcomes among patients receiving autologous reconstruction did not appear substantially worse than those of unirradiated patients by two years.”