Ontology type: schema:ScholarlyArticle Open Access: True
2021-11-14
AUTHORSMarco Bernini, Icro Meattini, Calogero Saieva, Carlotta Becherini, Viola Salvestrini, Luca Visani, Giulia Stocchi, Chiara Bellini, Victoria Lorenzetti, Silvia Sordi, Jacopo Nori, Diego De Benedetto, Isacco Desideri, Simonetta Bianchi, Lorenzo Livi, Lorenzo Orzalesi
ABSTRACTWe re-evaluated acute and early-late toxicity-related factors among pre-pectoral immediate tissue expander/implant (TE/I) breast reconstruction (BR) unselected, first-era, cases, including previous breast radiation treatment and post-mastectomy radiation therapy (PMRT). A retrospective analysis of 146 (117 therapeutic and 29 prophylactic) pre-pectoral reconstructions, between 2012 and 2016, considered patient-related (age, body mass index [BMI], smoke-history, comorbidity, BRCA mutation), and treatment-related characteristics (previous irradiation, axillary surgery, PMRT, pre- and postoperative chemotherapy, endocrine therapy, and target-therapy). Safety was evaluated as acute and early-late complications, and TE/I failures. At multivariate analysis of the 146 cases (117 patients submitted to BR) a significant factor related to acute toxicity was: BMI ≥ 25 (31.3% [≥ 25] vs 8.8% [< 25]; OR 4.44, 95% CI 1.56–12.6; p = 0.003), while previous breast surgery on ipsilateral side presented a borderline significance (31.6% [previous surgery] vs 7.4% [no previous surgery]; OR 3.74, 95% CI 0.97–14.40; p = 0.055). Factors significantly related to TE/I failure were: current or previous smoking exposition (13.8% [smokers] vs 2.6% [non-smokers]; OR 7.32, 95% CI 1.37–39.08; p = 0.02) and preoperative chemotherapy (18.8% [yes] vs 3.5% [no]; OR 8.16, 95% CI 1.29–51.63; p = 0.026). At 4-year median follow-up, 3 deaths, 5 locoregional recurrences, and 14 distant metastases occurred. Immediate pre-pectoral BR is safe and effective, with low rates of acute and early-late complications. BMI and previous breast surgery were related to higher complications but not failure; smoking and preoperative chemotherapy were related to TE/I explant. Previous RT and PMRT were related neither to early-late toxicity nor failure. More... »
PAGES302-313
http://scigraph.springernature.com/pub.10.1007/s12282-021-01314-0
DOIhttp://dx.doi.org/10.1007/s12282-021-01314-0
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PUBMEDhttps://www.ncbi.nlm.nih.gov/pubmed/34775540
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