Feasibility of breast-conservation therapy and hypofractionated radiation in the setting of prior breast augmentation Journal Article
| Authors: | Tadros, A. B.; Moo, T. A.; Zabor, E. C.; Gillespie, E. F.; Khan, A.; McCormick, B.; Cahlon, O.; Powell, S. N.; Allen, R. Jr; Morrow, M.; Braunstein, L. Z. |
| Article Title: | Feasibility of breast-conservation therapy and hypofractionated radiation in the setting of prior breast augmentation |
| Abstract: | Purpose: Cosmetic outcomes and rate of implant loss are poorly characterized among patients with breast cancer with previous breast augmentation (BA) who undergo breast-conservation therapy (BCT). Here we determine capsular contracture and implant loss frequency after BCT among patients receiving contemporary whole-breast radiation therapy (RT). Methods and Materials: Patients with breast cancer with a history of BA presenting to our institution from January 2006 to January 2017 who elected for BCT were included. Seventy-one breast cancers in 70 patients with a history of BA electing for BCT were retrospectively identified. Clinicopathologic, treatment, and outcome variables were examined. Whole-breast RT included conventional and hypofractionated schedules with and without a boost. Rates of implant loss and cosmetic outcomes among patients who did and did not develop a new/worse contracture based on physician assessment were compared. Results: In the study, 54.9% of patients received radiation using hypofractionated whole-breast tangents; 81.7% received a boost. In addition, 18 out of 71 cases (25.4%) developed a new/worse contracture after BCT with a mean follow-up of 1.9 years. Furthermore, 9 out of 71 cases (12.7%) were referred to a plastic surgeon for revisional surgery. There were no implant-loss cases. On univariate analysis, implant location, time from implant placement to diagnosis, RT type, RT boost, body mass index, and tumor size were not associated with new/worse contracture. Of 12 patients with existing contracture, only 2 developed worsening contracture. Physician assessment of cosmetic outcome after BCT was noted to be excellent or good for 87.4% of patients. Conclusions: BCT for breast cancer patients with prior history of BA has a low risk of implant loss. Hypofractionated RT does not adversely affect implant outcomes. Patients should be counseled regarding risk for capsular contracture, but the majority have good/excellent outcome; BA does not represent a contraindication to BCT. © 2020 American Society for Radiation Oncology |
| Journal Title: | Practical Radiation Oncology |
| Volume: | 10 |
| Issue: | 5 |
| ISSN: | 1879-8519 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2020-09-01 |
| Start Page: | e357 |
| End Page: | e362 |
| Language: | English |
| DOI: | 10.1016/j.prro.2020.01.003 |
| PUBMED: | 32006728 |
| PROVIDER: | scopus |
| PMCID: | PMC7483319 |
| DOI/URL: | |
| Notes: | Article -- Source: Scopus |
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