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The Impact of Adjuvant Radiotherapy on Immediate Prepectoral Implant-Based Breast Reconstruction

  • Original Articles
  • Breast Surgery
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Abstract

Background

Immediate prepectoral implant-based breast reconstruction (IBBR) rates have increased in recent years owing to improved cosmetic and psychological benefits. However, there is a lack of studies regarding complications rates following adjuvant radiotherapy (RT) among patients undergoing immediate prepectoral IBBR.

Methods

We conducted a retrospective monocentric analysis of a cohort of consecutively treated patients who underwent NSM following immediate prepectoral IBBR at our institution between March 2017 and November 2021. Patient demographics, quality of life, complication rates, and oncological safety were evaluated in the RT and non-RT groups. Data analysis was performed using IBM SPSS Version 24 (IMB Corp., Armonk, NY, USA).

Results

A total of 98 patients were examined: 70 were assigned to have prepectoral IBBR without RT and 28 to the group who had prepectoral IBBR with RT. There was a statistically significant difference in overall capsular contracture rate between the RT and non-RT group (18% vs. 4.3%, p=0.04). The total implant loss in the cohort was 4% (10.7% vs. 1.4%, p=0.05). We obtained a high percentages of all BREAST-Q categories in both groups; however, satisfaction with the breast and sexual well-being was higher in the non-RT group. The three-year overall survivals were 97.4% in the RT group and 98.5% in the non-RT group.

Conclusion

Our findings showed that patients in the RT group had a higher rate of capsular contracture and implant loss than those in the non-RT group. However, complication rates were within acceptable range and with accurate preoperative information patients have more benefits from immediate reconstruction showing excellent overall quality of life irrespectively of radiation.

Level of Evidence III

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Funding

The authors received no financial support for the research, authorship and publication of this article.

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Authors and Affiliations

  1. Department of Surgery and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria

    Edvin Ostapenko, Larissa Nixdorf, Yelena Devyatko, Ruth Exner, Kerstin Wimmer & Florian Fitzal

  2. Faculty of Medicine, Vilnius University, Vilnius, Lithuania

    Edvin Ostapenko

  3. Atomos Klinik Währing, Vienna, Austria

    Florian Fitzal

Authors
  1. Edvin Ostapenko
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  2. Larissa Nixdorf
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  3. Yelena Devyatko
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  4. Ruth Exner
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  6. Florian Fitzal
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Contributions

EO had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. EO, LN contributed to concept and design. All authors were involved in acquisition, analysis, or interpretation of data. EO, FF, RE contributed to drafting of the manuscript. All authors were involved in critical revision of the manuscript for important intellectual content. KW, YD contributed to statistical analysis. FF was involved in study supervision.

Corresponding author

Correspondence to Edvin Ostapenko.

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Conflict of interest

Dr. F.F. has received personal honoraries and educational grants from Pfizer, Novartis, Roche, Astra Zeneca, Springer, Medtronic and Bondimed. The remaining authors have no financial interests to declare in relation to the content of this article.

Ethical Approval

The ethics committee of the Medical University of Vienna approved this study (no. 1597/2021)

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For this type of study, informed consent is not required.

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Ostapenko, E., Nixdorf, L., Devyatko, Y. et al. The Impact of Adjuvant Radiotherapy on Immediate Prepectoral Implant-Based Breast Reconstruction. Aesth Plast Surg (2023). https://doi.org/10.1007/s00266-023-03661-z

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