Abstract
Given the high incidence of breast cancer in our society, it is common to encounter patients with macromastia who desire breast reduction after breast-conserving therapy by lumpectomy and radiation. We hypothesize that radiation leads to a significant increase in postoperative complications after breast reduction. All patients with a history of unilateral breast lumpectomy and radiation who subsequently underwent bilateral breast reduction by a single surgeon from 2004 to 2008 were retrospectively reviewed. Outcomes including cellulitis, wound breakdown, seroma, and need for repeat operations were compared between the radiated and nonradiated breast. The Fisher's exact test was used for statistical analysis. Twelve patients (mean age, 57 years) underwent bilateral breast reduction a mean of 86 months after unilateral lumpectomy and radiation. The nonradiated breasts had no complications postoperatively. The radiated breasts had a significant increase in complications with a total of five breasts (42%, p < 0.04) having postoperative complications including cellulitis in two breasts, seroma requiring drainage in five breasts, two cases of fat necrosis, and one case of wound dehiscence. This resulted in two admissions for intravenous antibiotics and two repeat operative procedures. Additionally, three patients had significant breast asymmetry or contour deformities after reduction requiring operative revisions. Breast reduction after radiation leads to a significant increase in complications. Given this data, patients with macromastia undergoing breast conservation therapy for cancer should be considered for reduction at the time of lumpectomy and prior to radiation.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 498-502 |
| Number of pages | 5 |
| Journal | Breast Journal |
| Volume | 16 |
| Issue number | 5 |
| DOIs | |
| State | Published - Sep 2010 |
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Keywords
- Breast reduction
- Breast-conserving therapy
- Radiation
- Reduction mammaplasty
ASJC Scopus subject areas
- Internal Medicine
- Surgery
- Oncology
Cite this
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Breast reduction in the irradiated breast : Evidence for the role of breast reduction at the time of lumpectomy. / Parrett, Brian M.; Schook, Carolyn; Morris, Donald.
In: Breast Journal, Vol. 16, No. 5, 09.2010, p. 498-502.Research output: Contribution to journal › Article
TY - JOUR
T1 - Breast reduction in the irradiated breast
T2 - Evidence for the role of breast reduction at the time of lumpectomy
AU - Parrett, Brian M.
AU - Schook, Carolyn
AU - Morris, Donald
PY - 2010/9
Y1 - 2010/9
N2 - Given the high incidence of breast cancer in our society, it is common to encounter patients with macromastia who desire breast reduction after breast-conserving therapy by lumpectomy and radiation. We hypothesize that radiation leads to a significant increase in postoperative complications after breast reduction. All patients with a history of unilateral breast lumpectomy and radiation who subsequently underwent bilateral breast reduction by a single surgeon from 2004 to 2008 were retrospectively reviewed. Outcomes including cellulitis, wound breakdown, seroma, and need for repeat operations were compared between the radiated and nonradiated breast. The Fisher's exact test was used for statistical analysis. Twelve patients (mean age, 57 years) underwent bilateral breast reduction a mean of 86 months after unilateral lumpectomy and radiation. The nonradiated breasts had no complications postoperatively. The radiated breasts had a significant increase in complications with a total of five breasts (42%, p < 0.04) having postoperative complications including cellulitis in two breasts, seroma requiring drainage in five breasts, two cases of fat necrosis, and one case of wound dehiscence. This resulted in two admissions for intravenous antibiotics and two repeat operative procedures. Additionally, three patients had significant breast asymmetry or contour deformities after reduction requiring operative revisions. Breast reduction after radiation leads to a significant increase in complications. Given this data, patients with macromastia undergoing breast conservation therapy for cancer should be considered for reduction at the time of lumpectomy and prior to radiation.
AB - Given the high incidence of breast cancer in our society, it is common to encounter patients with macromastia who desire breast reduction after breast-conserving therapy by lumpectomy and radiation. We hypothesize that radiation leads to a significant increase in postoperative complications after breast reduction. All patients with a history of unilateral breast lumpectomy and radiation who subsequently underwent bilateral breast reduction by a single surgeon from 2004 to 2008 were retrospectively reviewed. Outcomes including cellulitis, wound breakdown, seroma, and need for repeat operations were compared between the radiated and nonradiated breast. The Fisher's exact test was used for statistical analysis. Twelve patients (mean age, 57 years) underwent bilateral breast reduction a mean of 86 months after unilateral lumpectomy and radiation. The nonradiated breasts had no complications postoperatively. The radiated breasts had a significant increase in complications with a total of five breasts (42%, p < 0.04) having postoperative complications including cellulitis in two breasts, seroma requiring drainage in five breasts, two cases of fat necrosis, and one case of wound dehiscence. This resulted in two admissions for intravenous antibiotics and two repeat operative procedures. Additionally, three patients had significant breast asymmetry or contour deformities after reduction requiring operative revisions. Breast reduction after radiation leads to a significant increase in complications. Given this data, patients with macromastia undergoing breast conservation therapy for cancer should be considered for reduction at the time of lumpectomy and prior to radiation.
KW - Breast reduction
KW - Breast-conserving therapy
KW - Radiation
KW - Reduction mammaplasty
UR - http://www.scopus.com/inward/record.url?scp=77956822465&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=77956822465&partnerID=8YFLogxK
U2 - 10.1111/j.1524-4741.2010.00965.x
DO - 10.1111/j.1524-4741.2010.00965.x
M3 - Article
C2 - 21054644
AN - SCOPUS:77956822465
VL - 16
SP - 498
EP - 502
JO - Breast Journal
JF - Breast Journal
SN - 1075-122X
IS - 5
ER -