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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MSK Authors
  1. Monica Morrow
    772 Morrow
  2. Simon Nicholas Powell
    331 Powell
  3. Oren Cahlon
    158 Cahlon
  4. Emily Craig Zabor
    172 Zabor
  5. Beryl McCormick
    372 McCormick
  6. Tracy-Ann Moo
    96 Moo
  7. Atif Jalees Khan
    153 Khan
  8. Erin Faye Gillespie
    149 Gillespie
  9. Audree Blythe Tadros
    116 Tadros