Complication analysis of breast cancer patients aftermastectomy with immediate autologous breastreconstruction and adjuvant radiotherapy

Background: after the mastectomy, the complication is different dependingon the sequence and method of breast reconstruction and radiotherapy (rt).the aim of the current study was to investigate complication rates, relatedfactors, and time to complications in breast cancer patients who underwentmastectomy with immediate autologous breast reconstruction (iabr) andadjuvant rt. materials and methods: between april 2009 and january 2017,52 patients underwent mastectomy with iabr followed by rt. medicalrecords of patients were retrospectively reviewed. complications occurringafter rt initiation were evaluated in four aspects: fat necrosis, woundinfection, revision surgery, and re-reconstruction and classified into: 1) minorcomplication requiring only conservative treatment, and 2) majorcomplication requiring surgical correction. all patients received rt on thechest wall including total flap. ipsilateral axillary, supraclavicular and internalmammary regions were included at physician’s discretion. median rt dosewas 50.4 gy (range, 50.4 – 59.4 gy). results: median follow up duration was22.3 months (range, 5.3-98.6 months). complication after rt initiationoccurred in 9 (17.3%) patients. six (11.5%) patients showed minor complications. three (5.8%) patients developed major complications. median time to occurrence of complication after rt was 8.6 months (range, 1.8–25.1months). two-thirds of complications occurred within one year, while 88.9%occurred within two years after rt. no factor showed correlation withcomplication. conclusions: iabr followed by adjuvant rt may be a reasonableoption for patients who underwent mastectomy, in terms of postoperativecomplication. complications occur most frequently within 1 year afterinitiation of rt, and most occur within 2 years.