The Impact of Adjuvant Radiotherapy on Immediate Prepectoral Implant-Based Breast Reconstruction

Edvin Ostapenko; Larissa Nixdorf; Yelena Devyatko; Ruth Exner; Kerstin Wimmer; Florian Fitzal

doi:10.1007/s00266-023-03661-z

The Impact of Adjuvant Radiotherapy on Immediate Prepectoral Implant-Based Breast Reconstruction

Aesthetic Plast Surg. 2023 Sep 22. doi: 10.1007/s00266-023-03661-z. Online ahead of print.

Authors

Edvin Ostapenko^{1

2}, Larissa Nixdorf³, Yelena Devyatko³, Ruth Exner³, Kerstin Wimmer³, Florian Fitzal^{3

4}

Affiliations

¹ Department of Surgery and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria. ostapenko.edvin@gmail.com.
² Faculty of Medicine, Vilnius University, Vilnius, Lithuania. ostapenko.edvin@gmail.com.
³ Department of Surgery and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.
⁴ Atomos Klinik Währing, Vienna, Austria.

PMID: 37737875
DOI: 10.1007/s00266-023-03661-z

Abstract

Background: Immediate prepectoral implant-based breast reconstruction (IBBR) rates have increased in recent years owing to improved cosmetic and psychological benefits. However, there is a lack of studies regarding complications rates following adjuvant radiotherapy (RT) among patients undergoing immediate prepectoral IBBR.

Methods: We conducted a retrospective monocentric analysis of a cohort of consecutively treated patients who underwent NSM following immediate prepectoral IBBR at our institution between March 2017 and November 2021. Patient demographics, quality of life, complication rates, and oncological safety were evaluated in the RT and non-RT groups. Data analysis was performed using IBM SPSS Version 24 (IMB Corp., Armonk, NY, USA).

Results: A total of 98 patients were examined: 70 were assigned to have prepectoral IBBR without RT and 28 to the group who had prepectoral IBBR with RT. There was a statistically significant difference in overall capsular contracture rate between the RT and non-RT group (18% vs. 4.3%, p=0.04). The total implant loss in the cohort was 4% (10.7% vs. 1.4%, p=0.05). We obtained a high percentages of all BREAST-Q categories in both groups; however, satisfaction with the breast and sexual well-being was higher in the non-RT group. The three-year overall survivals were 97.4% in the RT group and 98.5% in the non-RT group.

Conclusion: Our findings showed that patients in the RT group had a higher rate of capsular contracture and implant loss than those in the non-RT group. However, complication rates were within acceptable range and with accurate preoperative information patients have more benefits from immediate reconstruction showing excellent overall quality of life irrespectively of radiation.

Level of evidence iii: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Keywords: Breast-Q; Immediate; Implant-based breast reconstruction; Prepectoral; Radiotherapy.