National breast reconstruction utilization in the setting of postmastectomy radiotherapy Journal Article

Authors: Razdan, S. N.; Cordeiro, P. G.; Albornoz, C. R.; Disa, J. J.; Panchal, H. J.; Ho, A. Y.; Momoh, A. O.; Matros, E.
Article Title: National breast reconstruction utilization in the setting of postmastectomy radiotherapy
Abstract: Background Immediate 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. Methods NCDB 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). Results In 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. Conclusion Although 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. © 2017 by Thieme Medical Publishers, Inc.
Keywords: breast reconstruction; postmastectomy radiotherapy; reconstruction and radiation
Journal Title: Journal of Reconstructive Microsurgery
Volume: 33
Issue: 5
ISSN: 0743-684X
Publisher: Thieme Medical Publishers, Inc.  
Date Published: 2017-06-01
Start Page: 312
End Page: 317
Language: English
DOI: 10.1055/s-0037-1598201
PROVIDER: scopus
PUBMED: 28235218
PMCID: PMC5885287
Notes: Article -- Export Date: 3 July 2017 -- Source: Scopus
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MSK Authors
  1. Alice Yoosun Ho
    109 Ho
  2. Joseph Disa
    194 Disa
  3. Peter G Cordeiro
    238 Cordeiro
  4. Evan Matros
    68 Matros
  5. Shantanu N Razdan
    13 Razdan