Abstract P3-14-09: Quality of life assessed by BREAST-Q in patients with delayed immediate tissue expander based breast reconstruction with and without radiotherapy
Authors: Hamann M , Brunnbauer M , Scheithauer H , Hamann U , Pölcher M , Braun M 
Published: May 2019

Introduction

Radiotherapy of the breast is known for having a negative impact on implant based breast reconstruction. Technical improvements, such as expander-implant based delayed immediate reconstruction (EIBR), seem to produce better results. The purpose of this study was to analyze the effects of prior radiotherapy (RT) and postmastectomy radiotherapy (PMRT) on patient-reported quality of life (QoL) in patients with EIBR compared to patients that underwent EIBR without any RT.

Material and methods

After a retrospective chart review, all patients with a history of EIBR at the Red Cross Hospital Munich were invited for a structured physical examination and interview. All operations were performed between 2008 and 2012 by two surgeons (H.U. and B.M.). To assess QoL, the BREAST-Q - post reconstruction module was used and results were compared between the following three cohorts: 1. patients without RT (n=65), 2. patients with PMRT (n= 27) and 3. patients with a history of breast irradiation before mastectomy (n=16). Patients with prior RT and a PMRT after local relapse were excluded.

Results

Of 161 patients eligible, 94 patients followed the invitation, 14 of them with bilateral EIBR. Baseline characteristics between participating and non-participating patients were comparable. The median follow-up time was 18.1 months. Most of the baseline

characteristics (e.g. tobacco use, diabetes) were comparable between the cohorts. Application of (neo-) adjuvant chemotherapy was significantly more frequent in cohort 2. The category Satisfaction with the breast was numerically but not significantly

better in cohort 1 than in cohort 2 (p 0,078) whereas the psychosocial well-being showed a trend in favor of cohort 2 (p 0,058). Satisfaction with breast was significantly better in cohort 1 than 3 (p 0,014) as well as Satisfaction with breast (implant only) (p=0,007). There was no difference for Satisfaction with outcome (p=0,666). Cohort 2 reached more points in all categories than cohort 3 although this difference was not significant. Of all patients, 92,7 %, 84,6 % and 78,6% (cohorts 1, 2 and 3) would undergo the operation again.

Conclusion

After short follow-up time, EIBR seems to be a feasible method for breast reconstruction resulting in a high QoL, even if PMRT is required. In patients with a prior RT, QoL is worse compared to the other groups. However, patients´ acceptance of EIBR is still high. Prospective studies and long-term follow-up are required for definitive conclusions.

Citation Format: Hamann M, Brunnbauer M, Scheithauer H, Hamann U, Pölcher M, Braun M. Quality of life assessed by BREAST-Q in patients with delayed immediate tissue expander based breast reconstruction with and without radiotherapy [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P3-14-09.