Long-Term Outcomes of Autologous Breast Reconstruction with or without Post-Mastectomy Radiotherapy

Area of Science:

• Oncology
• Plastic Surgery
• Radiotherapy

Background:

• Autologous breast reconstruction offers excellent cosmetic results and patient satisfaction.
• The impact of postmastectomy radiotherapy (PMRT) on autologous reconstruction outcomes is debated.
• This study evaluates long-term results of autologous breast reconstruction with and without PMRT.

Purpose of the Study:

• To assess the long-term complications and patient-reported outcomes of autologous breast reconstruction following PMRT.
• To compare outcomes between patients who received PMRT and those who did not.

Main Methods:

• Prospective follow-up of patients undergoing mastectomy and immediate autologous reconstruction (2018-2023).
• Categorization into PMRT (n=43) and non-PMRT (n=59) groups.
• Assessment of complications and patient-reported outcomes using BREAST-Q, with logistic regression analysis.

Main Results:

• Higher overall complication rates in the PMRT group (46.5%) versus the non-PMRT group (23.7%).
• Increased fat necrosis and flap fibrosis observed in the PMRT group.
• Lower physical well-being and satisfaction scores in the PMRT group; psychosocial well-being scores were similar.
• IMRT and VMAT techniques were associated with fewer complications and better outcomes than 3D radiotherapy.

Conclusions:

• PMRT elevates complication risks in autologous breast reconstruction, yet overall patient satisfaction remains high.
• Advanced radiotherapy techniques (IMRT, VMAT) show potential in mitigating radiation-induced adverse effects.
• Further research is needed to optimize reconstruction methods and patient selection for improved long-term results.