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Title: Inverse radiotherapy planning in reconstructive surgery for breast cancer
Authors: Tejera Hernández, Ana Alicia
Vega Benítez, Víctor Manuel 
Rocca Cardenas, Juan Carlos
Ortega Pérez, Neith
Rodríguez Ibarria, Nieves
Gutiérrez Giner, María Isabel 
Pérez Correa, Pedro
Díaz Chico, Juan Carlos 
Hernández Hernández, Juan Ramón 
UNESCO Clasification: 320101 Oncología
320112 Radioterapia
Keywords: Aesthetic Results
Breast Cancer
Post-Mastectomy Radiotherapy
Satisfaction Degree
Issue Date: 2019
Journal: International Journal of Surgery 
Abstract: Post-mastectomy radiotherapy reduces the risk of local-regional relapse and distant disease, and increases global survival in women with axillary involvement. With the new reconstruction techniques and increasing use of directed external radiotherapy, immediate reconstruction can be performed with good cosmetic results and low complication rates. Materials and methods: Observational study with consecutive sampling conducted in patients undergoing reconstructive surgery for breast cancer, between 2010 and 2016, with a 12-months minimum follow-up period. A group of patients radiated after receiving an expander (RT-Expander) were compared with a control group of non-radiated patients (Non-RT), who had been treated with the same surgical technique. We compare general complications, reconstruction failure, aesthetic results and satisfaction degree with software IBM® SPSS® Statistics v. 21 and BREAST-Q scores. Results: Reconstruction failure was observed in 15.6% of patients in a similar proportion in both groups. External radiotherapy was not an independent significant factor influencing the occurrence of general complications, capsular contracture grade ≥3 or reconstruction failure. The Kaplan-Meyer curve showed no differences in reconstruction survival between groups. Aesthetic results were excellent-very good in 78.1% of patients. Absence of a contralateral procedure for symmetrization, occurrence of general complications, occurrence of capsular contracture grade ≥3 and reconstruction failure were significantly associated to fair-poor cosmetic results. The satisfaction degree of operated patients was similar in both groups. Conclusions: The evolution of external radiotherapy towards more directed techniques, which modulate the dose administered to the mammary tissue and adjacent structures, allowed us to make immediate reconstruction a reality for most patients, with complication rates, cosmetic results and satisfaction degrees similar to those of non-radiated patients.
ISSN: 1743-9191
DOI: 10.1016/j.ijsu.2019.01.017
Source: International Journal of Surgery [ISSN 1743-9191], v. 63, p. 77-82
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