Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Republic of Korea.
Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Breast Cancer. 2024 May;31(3):391-400. doi: 10.1007/s12282-024-01547-9. Epub 2024 Feb 18.
As breast augmentation has become more popular, an increasing number of women with augmented breasts require treatment for breast cancer. This study aimed to assess the outcomes of postoperative whole breast radiation therapy (WB-RT) in Asian patients with breast cancer who underwent prior cosmetic breast implantation.
We retrospectively reviewed the medical records of 61 patients with breast cancer who had prior cosmetic breast implants (prior-CBI) and underwent breast-conserving surgery (BCS) and WB-RT between 2015 and 2020. The median implant volume was 238.8 cc, with a median interval of 84.7 months between the prior-CBI and BCS. WB-RT was administered with either conventional fractionation (CF-RT) at 50 Gy in 25 fractions (N = 36) or hypofractionation (HF-RT) at 42.6 Gy in 16 fractions (N = 25). The incidences of implant-related complications (IRC) and their contributing factors were analyzed.
After a median follow-up of 43.5 months, the 3-year cumulative incidences of IRC and implant loss were 17.2% and 4.9%, respectively. Among the four (6.6%) patients who opted for implant removal after RT, three were potentially related to RT-related capsular contracture. There was no difference in the 3-year cumulative IRC rates following CF-RT and HF-RT (12.2% and 26.7%, respectively; p = 0.120). The risk factors for IRC included a larger implant size (> 260 cc) and a higher ratio of breast tissue to implant volume.
This study demonstrated a favorable safety profile of WB-RT for treatment of breast cancer in Asian women with prior-CBI. The integration of HF-RT following BCS was thought to be a feasible approach.
随着隆胸术的普及，越来越多的隆乳女性需要接受乳腺癌治疗。本研究旨在评估亚洲隆乳女性乳腺癌患者接受保乳手术后全乳放疗（WB-RT）的治疗效果。
我们回顾性分析了 2015 年至 2020 年间 61 例接受过美容乳房植入物（先前 CBI）且接受过保乳手术（BCS）和 WB-RT 的乳腺癌患者的病历。植入物的中位体积为 238.8cc，先前 CBI 和 BCS 之间的中位间隔为 84.7 个月。WB-RT 采用常规分割（CF-RT），50Gy/25 次（N=36）或低分割（HF-RT），42.6Gy/16 次（N=25）。分析了植入物相关并发症（IRC）的发生率及其相关因素。
中位随访 43.5 个月后，IRC 和植入物丢失的 3 年累积发生率分别为 17.2%和 4.9%。在接受 RT 后选择取出植入物的 4 名（6.6%）患者中，有 3 名可能与 RT 相关的包膜挛缩有关。CF-RT 和 HF-RT 的 3 年 IRC 累积发生率无差异（分别为 12.2%和 26.7%；p=0.120）。IRC 的危险因素包括较大的植入物尺寸（>260cc）和乳房组织与植入物体积的比例较高。
本研究表明，亚洲接受过先前 CBI 的乳腺癌患者接受 WB-RT 治疗具有良好的安全性。BCS 后采用 HF-RT 是一种可行的方法。
