Yun Ji Young, Ahn Ki Jung, Kim Hyunjung, Kim Hee Yeon, Kim Tae Hyun, Byun Kyung Do, Park Ji Sun, Choi Yunseon
Department of Plastic Surgery, Inje University Busan Paik Hospital, Inje University School of Medicine, Busan, Korea.
Department of Radiation Oncology, Inje University Busan Paik Hospital, Inje University School of Medicine, Busan, Korea.
Ann Surg Treat Res. 2025 May;108(5):295-301. doi: 10.4174/astr.2025.108.5.295. Epub 2025 Apr 28.
This study aimed to analyze whether the occurrence of complications increases if radiotherapy (RT) is administered after breast reconstructive surgery using implants.
This retrospective study included 80 patients who underwent breast reconstruction using implants, of which 16 (20.0%) underwent RT. Most patients underwent conventional fractionated RT (n = 13), and hypofractionated RT was performed in 3 patients. Most patients (n = 51, 63.8%) underwent delayed reconstruction, which involved implant replacement after tissue expander insertion. Only 29 patients (36.3%) underwent immediate reconstruction simultaneously with breast cancer surgery.
The median postoperative follow-up was 39.9 months (range, 8.7-120.3 months). Complications occurred in 18 (22.5%); infection/necrosis (n = 8), leakage/rupture (n = 8), and capsular contracture (n = 2). Infection/necrosis is common in patients undergoing RT. Complications occurred in 4 patients (25.0%) who received RT and 14 (21.9%) who did not receive RT, and complications did not significantly increase with RT (P = 0.511). There was no overall difference in complications between the immediate (4 of 29) and delayed (14 of 51) reconstruction groups (P = 0.129). Nine patients underwent reoperation because of complications; 3 (18.8%) received RT and 6 (9.4%) did not receive RT. The reoperation rate did not increase significantly with RT (P = 0.254). There were 3 cases of recurrence, and patients who received RT had no recurrence.
RT did not significantly increase the complication or reoperation rates if reconstructive surgery was performed using implants. Therefore, RT should be performed in patients at a high risk of recurrence.
本研究旨在分析使用植入物进行乳房重建手术后进行放射治疗（RT）是否会增加并发症的发生率。
这项回顾性研究纳入了80例行植入物乳房重建的患者，其中16例（20.0%）接受了RT。大多数患者接受了常规分割放疗（n = 13），3例患者接受了大分割放疗。大多数患者（n = 51，63.8%）接受了延迟重建，即组织扩张器植入后进行植入物置换。只有29例患者（36.3%）在乳腺癌手术的同时进行了即刻重建。
术后中位随访时间为39.9个月（范围8.7 - 120.3个月）。18例（22.5%）出现并发症；感染/坏死（n = 8）、渗漏/破裂（n = 8）和包膜挛缩（n = 2）。感染/坏死在接受RT的患者中很常见。接受RT的4例患者（25.0%）和未接受RT的14例患者（21.9%）出现并发症，RT并未显著增加并发症发生率（P = 0.511）。即刻重建组（29例中的4例）和延迟重建组（51例中的14例）之间并发症无总体差异（P = 0.129）。9例患者因并发症接受了再次手术；3例（18.8%）接受了RT，6例（9.4%）未接受RT。再次手术率并未因RT而显著增加（P = 0.254）。有3例复发，接受RT的患者未复发。
如果使用植入物进行重建手术，RT不会显著增加并发症或再次手术率。因此，应在复发风险高的患者中进行RT。
