Complication analysis of breast cancer patients after mastectomy with immediate autologous breast reconstruction and adjuvant radiotherapy

Background: After the mastectomy, the complicaton is different depending on the sequence and method of breast reconstructon and Radiotherapy (RT). The aim of the current study was to investgate complicaton rates, related factors, and tme to complicatons in breast cancer patents who underwent mastectomy with immediate autologous breast reconstructon (IABR) and adjuvant RT. Materials and Methods: Between April 2009 and January 2017, 52 patents underwent mastectomy with IABR followed by RT. Medical records of patents were retrospectvely reviewed. Complicatons occurring after RT initaton were evaluated in four aspects: fat necrosis, wound infecton, revision surgery, and re-reconstructon and classified into: 1) minor complicaton requiring only conservatve treatment, and 2) major complicaton requiring surgical correcton. All patents received RT on the chest wall including total flap. Ipsilateral axillary, supraclavicular and internal mammary regions were included at physician's discreton. Median RT dose was 50.4 Gy (range, 50.4 - 59.4 Gy). Results: Median follow up duraton was 22.3 months (range, 5.3-98.6 months). Complicaton after RT initaton occurred in 9 (17.3%) patents. Six (11.5%) patents showed minor complicatons. Three (5.8%) patents developed major complicatons. Median tme to occurrence of complicaton after RT was 8.6 months (range, 1.8-25.1 months). Two-thirds of complicatons occurred within one year, while 88.9% occurred within two years after RT. No factor showed correlaton with complicaton. Conclusions: IABR followed by adjuvant RT may be a reasonable opton for patents who underwent mastectomy, in terms of postoperatve complicaton. Complicatons occur most frequently within 1 year after initaton of RT, and most occur within 2 years.