Kim Seong Hwan, Kim Jeong Min, Park Sun Hyung, Lee Sam Yong
Department of Plastic and Reconstructive Surgery, Chonnam National University Hospital, Chonnam National University School of Medicine, Gwangju, Korea.
Arch Plast Surg. 2012 May;39(3):222-6. doi: 10.5999/aps.2012.39.3.222. Epub 2012 May 10.
Immediate breast reconstruction after mastectomy and delayed breast reconstruction with post-supplementary treatment are the two types of breast reconstruction currently performed when treating breast cancer. Post-mastectomy radiation therapy (PMRT) not only reduces local recurrence but also improves overall survival. However, the complications and survival rates associated with PMRT need to be clear when determining the timing of breast reconstruction. Accordingly, we investigated the optimal timing of breast reconstruction by observing patients who underwent mastectomy followed by PMRT, based on their overall health and aesthetic satisfaction.
We retrospectively reviewed 21 patients who underwent breast reconstruction with PMRT between November 2004 and November 2010. We collected data regarding the various methods of mastectomy, and the modality of adjuvant therapy, such as chemotherapy, hormone therapy, and radiotherapy. Telephone interviews were conducted to study the general and aesthetic satisfaction.
Patients who received PMRT after breast reconstruction showed a greater complication rate than those undergoing breast reconstruction after PMRT (P=0.02). Aesthetic satisfaction was significantly higher in the groups undergoing breast reconstruction after PMRT (P=0.03). Patients who underwent breast reconstruction before PMRT developed complications more frequently, but they expressed greater aesthetic satisfaction with the treatment.
It is recommended that the complication rates and aesthetic satisfaction after breast reconstruction be carefully considered when determining the optimal timing for radiotherapy.
乳房切除术后即刻乳房重建以及辅助治疗后的延迟乳房重建是目前治疗乳腺癌时进行乳房重建的两种类型。乳房切除术后放疗(PMRT)不仅能降低局部复发率,还能提高总体生存率。然而,在确定乳房重建时机时,与PMRT相关的并发症和生存率需要明确。因此,我们通过观察接受乳房切除术后再进行PMRT的患者,基于其整体健康状况和美学满意度,研究了乳房重建的最佳时机。
我们回顾性分析了2004年11月至2010年11月期间接受PMRT乳房重建的21例患者。我们收集了有关各种乳房切除方法以及辅助治疗方式的数据,如化疗、激素治疗和放疗。通过电话访谈来研究总体满意度和美学满意度。
乳房重建后接受PMRT的患者并发症发生率高于PMRT后进行乳房重建的患者(P = 0.02)。PMRT后进行乳房重建的组美学满意度显著更高(P = 0.03)。在PMRT前进行乳房重建的患者并发症发生频率更高,但他们对治疗的美学满意度更高。
在确定放疗的最佳时机时,建议仔细考虑乳房重建后的并发症发生率和美学满意度。