Effect of internal mammary vessels radiation dose on outcomes of free flap breast reconstruction

Breast J. 2019 Mar;25(2):286-289. doi: 10.1111/tbj.13202. Epub 2019 Feb 8.

Abstract

To assess the impact of internal mammary (IM) vessels radiation dose on autologous free-flap based breast reconstruction outcomes. We retrospectively evaluated the medical records of breast cancer patients who underwent mastectomy and free-flap breast reconstruction after postoperative radiation therapy (RT) to the breast/chest wall with (n = 9) or without (n = 11) electively including the IM lymph nodes. Twenty patients were included. Median age at diagnosis was 50 years (range, 33-63). The median time interval between the start of RT and reconstructive surgery was 16 months (range, 6-45). The maximal IM vessels dose was not associated with the risk of all complications (P = 0.44) or fat necrosis (P = 0.31). The mean IM vessels dose was not significant for the risk of all complications (P = 0.13) but was significant for fat necrosis (P = 0.04). A high mean IM vessels dose was related to the occurrence of fat necrosis.

Keywords: breast cancer; complications; dose; flap; internal mammary vessels; radiation therapy; reconstruction.

MeSH terms

  • Adult
  • Anastomosis, Surgical
  • Blood Vessels / radiation effects
  • Breast Neoplasms / radiotherapy*
  • Breast Neoplasms / surgery*
  • Dose-Response Relationship, Radiation
  • Female
  • Free Tissue Flaps
  • Humans
  • Mammaplasty / adverse effects*
  • Mammaplasty / methods
  • Mammary Glands, Human / blood supply*
  • Mammary Glands, Human / radiation effects
  • Middle Aged
  • Postoperative Complications / etiology
  • Radiotherapy Dosage*
  • Retrospective Studies
  • Time Factors