Implant-based immediate breast reconstruction: failure rate when radiating the tissue expander or the permanent...

Area of Science:

• Plastic Surgery
• Oncology
• Radiotherapy

Background:

• Implant-based immediate breast reconstruction is a primary option for mastectomy defects.
• Post-mastectomy radiation therapy (PMRT) can be delivered to either the temporary tissue expander (TTE) or the permanent implant (PI).

Purpose of the Study:

• To compare the reconstructive failure (RF) rate between PMRT delivered to TTE versus PMRT delivered to PI.
• To identify potential risk factors for RF in implant-based breast reconstruction.

Main Methods:

• A systematic literature search was conducted on PUBMED/MEDLINE (January 2008-January 2019).
• Ten articles (n=1,130) were selected for meta-analysis.
• A literature review was performed to identify risk factors for RF.

Main Results:

• A meta-analysis indicated a tendency towards a higher RF rate when TTE was irradiated compared to PI.
• An odds ratio (OR) of 1.85 (0.96, 3.57; P=0.067) was obtained in the random-effect model.
• A funnel plot suggested no publication bias.

Conclusions:

• There is a trend indicating higher reconstructive failure rates when temporary tissue expanders are irradiated versus permanent implants.
• Further studies are required to clarify the influence of risk factors and establish consensus on reconstructive modality indications.