Delayed breast implant reconstruction: is radiation therapy associated with capsular contracture or reoperations?

Abstract

We evaluated the association between radiation therapy and severe capsular contracture or reoperation after 717 delayed breast implant reconstruction procedures (288 1- and 429 2-stage procedures) identified in the prospective database of the Danish Registry for Plastic Surgery of the Breast during the period between 1999 and 2006. A history of radiation therapy was associated with increased risk of severe capsular contracture for 1- and 2-stage procedures, with adjusted hazard ratios (HR) of 3.3 (95% confidence interval [CI]: 0.9-12.4) and 7.2 (95% CI: 2.4-21.4), respectively. Similarly, a history of radiation therapy was associated with a non-significantly increased risk of reoperation after both 1-stage (HR = 1.4; 95% CI: 0.7-2.5) and 2-stage (HR = 1.6; 95% CI: 0.9-3.1) procedures. Reconstruction failure was highest (13.2%) in the 2-stage procedures with a history of radiation therapy. Breast reconstruction approaches other than implants should be seriously considered among women who have received radiation therapy.

• Authors: Gitte Bjørn Hvilsom, Lisbet Rosenkrantz Hölmich, Marianne Steding-Jessen, Kirsten Frederiksen, Trine Foged Henriksen, Loren Lipworth, Joseph McLaughlin, Jens Jørgen Elberg, Tine Engberg Damsgaard, Søren Friis
• Journal: Annals of plastic surgery (Ann Plast Surg) Vol. 68 Issue 3 Pg. 246-52 (Mar 2012) ISSN: 1536-3708 [Electronic] United States
• PMID: 21540726 (Publication Type: Journal Article)

Topics

• Adult
• Breast (surgery)
• Breast Implantation (adverse effects, statistics & numerical data)
• Breast Implants (adverse effects, statistics & numerical data)
• Breast Neoplasms (drug therapy, radiotherapy, surgery)
• Causality
• Cohort Studies
• Comorbidity
• Denmark (epidemiology)
• Female
• Humans
• Implant Capsular Contracture (epidemiology, etiology)
• Mammaplasty (adverse effects, methods, statistics & numerical data)
• Proportional Hazards Models
• Radiotherapy (adverse effects, statistics & numerical data)
• Registries
• Reoperation
• Risk Factors
• Time Factors