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Studies identify complications in women undergoing mastectomy and immediate breast reconstruction
Date:9/20/2010

About half of women who require radiation therapy after they have had a mastectomy and immediate breast reconstruction develop complications that necessitate a return to the operating room, but pre- or post-mastectomy chemotherapy does not appear to be associated with the need for additional procedures, according to two reports in the September issue of Archives of Surgery, one of the JAMA/Archives journals.

An increasing number of women are undergoing mastectomy as a treatment for breast cancer or as a means to prevent cancer if they have a genetic predisposition, according to background information in the articles. Previously, most women underwent mastectomy and then radiation or chemotherapy, followed by a second procedure for breast reconstruction after completing therapy. However, many treatment facilities now offer the option of having breast reconstruction at the same time as mastectomy. Studies suggest immediate reconstruction is safe and has potential psychological and aesthetic benefits.

Rates of radiation therapy after mastectomy are also increasing. In one article, Dara Christante, M.D., and colleagues at Oregon Health & Science University Knight Cancer Institute, Portland, studied 302 mastectomy patients with stage I to III breast cancer treated between 2000 and 2008, identified via an institutional cancer registry. Of the 302 women, 152 had breast reconstructions, including 131 that were immediate; 183 (60 percent) underwent biopsies to detect malignancy in their lymph nodes, of whom 108 (59 percent) had a negative finding; and 100 underwent postmastectomy irradiation to the chest wall.

"Postmastectomy irradiation and immediate breast reconstruction were each indentified as strong independent predictors of complications," the authors write. "Postmastectomy irradiation tripled the risk for an unplanned return to the operating room and immediate breast reconstruction increased that risk eight-fold. The combination o
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Contact: Elisa Williams
willieli@ohsu.edu
503-494-8231
JAMA and Archives Journals
Source:Eurekalert

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