News | Radiation Therapy | January 02, 2017

Radiation Therapy May Increase Complications in Breast Cancer Patients Receiving Implants

Patients who received autologous breast reconstruction after radiotherapy had no worsening of outcomes

radiation therapy complications with implant reconstruction, autologous reconstruction

January 2, 2017 — Radiotherapy increased complications and impaired patient-reported satisfaction with reconstructed breasts in breast cancer patients who received implant reconstruction but not in those who received autologous reconstruction, according to data from a large, prospective, multicenter cohort study presented at the 2016 San Antonio Breast Cancer Symposium in December.

Autologous breast reconstruction is a procedure in which a woman's own body tissues are used to create a new breast after breast cancer surgery.

"There is growing evidence supporting the benefits of post-mastectomy radiotherapy in appropriate patients, but many patients still must decide whether they feel that the benefits given their particular circumstances outweigh the risks," said Reshma Jagsi, M.D., D.Phil, professor and deputy chair in the Department of Radiation Oncology at the University of Michigan. "One of the risks of radiation therapy is that it may affect the options and outcomes for breast reconstruction, which many women who receive mastectomy desire."

Women diagnosed with early-stage breast cancer face challenging decisions that will impact both their long-term disease control and quality of life, Jagsi said. Because many women who undergo mastectomy become long-term survivors, breast reconstruction can have a lasting impact on quality of life. Optimal approaches to integrate post-mastectomy radiotherapy and breast reconstruction are not well established thus far, she added.

Jagsi and colleagues conducted a multicenter cohort study called the Mastectomy Reconstruction Outcomes Consortium (MROC), in which they collected medical data and patient-reported outcomes data from 553 and 1,461 patients who did and did not receive radiotherapy, respectively. About 38 percent and 25 percent of the patients who did and did not receive radiotherapy, respectively, received autologous reconstruction, and the rest received implant reconstruction.

The researchers assessed if radiotherapy was associated with developing complications after breast reconstruction, such as hematoma and wound infection, and measured patients' satisfaction with the outcome using a BREAST-Q patient-reported outcome instrument, one and two years after reconstruction.

After a year of follow-up, 28.8 and 22.3 percent of the patients who did and did not receive radiotherapy, respectively, had at least one of the complications measured. After two years of follow-up, 34.1 percent of the patients who received radiotherapy and 22.5 percent of those who did not receive radiotherapy experienced reconstruction-related complications.

When the researchers took several variables into account, radiotherapy was associated with more than double the odds of developing complications in patients who received implants, but it was not associated with complications in those who received autologous reconstruction.

Based on BREAST-Q scores, patient-reported satisfaction was significantly lower in those who received radiation versus those who did not receive radiation among patients who received implants, but no such differences were found among patients who received autologous reconstruction.

"Although women must still weigh multiple factors, including the differences in operative time and rehabilitation required for different approaches, when selecting their preferred type of reconstruction, those who plan to receive post-mastectomy radiation therapy should be informed of the substantial and significant impact of radiotherapy observed in the current study among patients who received implant reconstruction," Jagsi said.

"Conversely, 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," she added.

A limitation of this study is that it is observational and does not establish cause-effect relationship. Further, patients treated at centers that are particularly skilled in integrating implant-based approaches with radiotherapy may still do well with such an approach, Jagsi noted.

This study was funded by the National Cancer Institute. Jagsi declares no conflict of interest.

Abstract Publication Number: S3-07 
Title: Impact of radiotherapy on complications and patient-reported satisfaction with breast reconstruction: Findings from the prospective multicenter MROC study 
Presented: Thursday, Dec. 8, General Session 3 - Hall 3, 11 a.m. CT

For more information: www.sabcs.org  

Related Content

Transpara Deep Learning Software Matches Experienced Radiologists in Mammogram Reading
News | Computer-Aided Detection Software | January 12, 2018
Deep learning and artificial intelligence improves the efficiency and accuracy of reading mammograms, according to...
Fat Distribution in Women and Men Provides Clues to Heart Attack Risk
News | Women's Health | January 11, 2018
January 11, 2018 – It’s not the amount of fat in your body but where it is stored that may increase your risk for hea
Women Prefer Getting Mammograms Every Year
News | Mammography | January 09, 2018
Women prefer to get their mammograms every year, instead of every two years, according to a new study presented at the...
Planmed Clarity 2-D Digital Mammography System Receives FDA Approval
Technology | Mammography | January 08, 2018
The U.S. Food and Drug Administration (FDA) issued an approval letter for the Planmed Clarity 2-D full-field digital...
Overweight Women May Need More Frequent Mammograms
News | Mammography | January 04, 2018
Women with higher body mass index (BMI) face an increased risk of not detecting their breast tumor until it has become...
Mevion Receives 510(k) Clearance for Hyperscan Pencil Beam Scanning Proton Therapy
Technology | Proton Therapy | January 04, 2018
Mevion Medical Systems has received U.S. Food and Drug Administration (FDA) 510(k) clearance for the Mevion S250i...
Study Compares Radiosurgery and Whole-Brain Radiation in Lung Cancer Patients With Multiple Brain Metastases
News | Radiation Therapy | January 03, 2018
Although targeted therapies have produced dramatic advances in the ability to control some types of advanced lung...
About 25 percent of screening patients and 60 percent of diagnostic patients do not have prior mammograms available for comparison at the time of their examinations due to the lack of interoperability or other restrictions preventing clinicians from accessing prior exams.

About 25 percent of screening patients and 60 percent of diagnostic patients do not have prior mammograms available for comparison at the time of their examinations due to the lack of interoperability or other restrictions preventing clinicians from accessing prior exams.

Feature | Breast Imaging | January 02, 2018 | Kathryn Pearson Peyton, M.D.
Sixty million women undergo regular screening mammography in the United States, but even in the digital age, it is di
MEDraysintell Downgrades Proton Therapy Market Projection for 2030
News | Proton Therapy | January 02, 2018
MEDraysintell recently downgraded its projection for proton therapy rooms expected to be operational in 2030 from 1,200...
Imagio Opto-Acoustic Breast Imaging System Helps Differentiate Tumor Subtypes
News | Oncology Diagnostics | January 02, 2018
Seno Medical Instruments Inc. (Seno Medical) recently reported data from their clinical study demonstrating that its...
Overlay Init