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방사선종양학
- 2021년 03월호
[BMC Cancer.] Does chemotherapy or radiotherapy affect the postoperative complication in breast cancer patients who underwent immediate breast reconstruction with tissue expander?성균관의대 / 정성미, 전병준, 이정언*
- 출처
- BMC Cancer.
- 등재일
- 2021 Jan 22
- 저널이슈번호
- 21(1):88. doi: 10.1186/s12885-020-07729-w.
- 내용
Abstract
Background: Immediate breast reconstruction with tissue expander in breast cancer patients who were expected to receive adjuvant therapy, such as chemotherapy or radiotherapy, has been a topic of debate. Postoperative complications from tissue expander procedures can delay the timing of adjuvant treatment and subsequently increase the probability of recurrence. The purpose of this study was to identify the impact of chemotherapy and radiotherapy on postoperative complications in patients who underwent immediate reconstruction (IR) using tissue expander.Methods: We conducted a retrospective study of 1081 breast cancer patients who underwent mastectomy and IR using tissue expander insertion between 2012 and 2017 in Samsung Medical Center. The patients were divided into two groups based on complications (complication group vs. no complication group). Complication group was regarded to have surgical removal or conservative treatment based on clinical findings such as infection, capsular contracture, seroma, hematoma, rupture, malposition, tissue viability, or cosmetic problem. The complication group had 59 patients (5.5%) and the no complication group had 1022 patients (94.5%).
Results: In univariate analysis, adjuvant radiotherapy and adjuvant chemotherapy were significantly associated with postoperative complications. In multivariate analysis, however, only higher pathologic N stage was significantly associated with postoperative complications (p < 0.001). Chemotherapy (p = 0.775) or radiotherapy (p = 0.825) were not risk factors for postoperative complications.
Conclusions: IR with tissue expander after mastectomy may be a treatment option even when the patients are expected to receive adjuvant chemotherapy or radiotherapy. These results will aid patients who are concerned about the complications of IR caused by chemotherapy or radiotherapy determine whether or not to have IR.
Affiliations
Sung Mi Jung # 1 , Byung-Joon Jeon # 2 , Jinsun Woo 1 , Jai Min Ryu 1 , Se Kyung Lee 1 , Byung-Joo Chae 1 , Jonghan Yu 1 , Seok Won Kim 1 , Seok Jin Nam 1 , Jai-Kyong Pyon 2 , Goo-Hyun Mun 2 , Sa Ik Bang 2 , Jeong Eon Lee 3
1 Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 81, Gangnam-gu, 06351, Seoul, South Korea.
2 Department of Plastic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 81, Gangnam-gu, 06351, Seoul, South Korea.
3 Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Irwon-ro 81, Gangnam-gu, 06351, Seoul, South Korea. jeongeon.lee@samsung.com.
# Contributed equally.
- 키워드
- Breast neoplasm; Chemotherapy, Adjuvant; Postoperative complications; Radiotherapy; Tissue expansion devices.
- 덧글달기
- 이전글 [Sci Rep.] Assessment of planning reproducibility in three-dimensional field-in-field radiotherapy technique for breast cancer: impact of surgery-simulation interval
- 다음글 [Int J Colorectal Dis.] Determining whether postoperative chemoradiotherapy is required in patients with pathologic T3N0 rectal cancer with negative resection margin
편집위원
유방암에서 immediate breast reconstruction(IR)이 postop Cx에 차이가 없다는 여러 보고에도 불구하고 clinical setting에서는 여전히 주저하게 되는데, 국내 단일기관에서 대규모 환자를 대상으로 분석한 연구로 IR이 수술 후 추가된 CTx or RT로 Cx이 증가하지 않는다는 기존의 consensus를 확인하였으며 대신 N stage가 높은 경우 수술시 발생하는 lymphatic drainage 손상으로 postop wound healing에 영향을 줄 수 있으므로 IR을 고려하는 환자들에서 참고할만한 근거연구로 생각됩니다.
덧글달기닫기2021-03-08 10:41:28
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