Breast cancer implant reconstructive surgery and radiotherapy: a retrospective analysis of medical records.

[PURPOSE] This study aimed to analyze whether the occurrence of complications increases if radiotherapy (RT) is administered after breast reconstructive surgery using implants.

[METHODS] This retrospective study included 80 patients who underwent breast reconstruction using implants, of which 16 (20.0%) underwent RT. Most patients underwent conventional fractionated RT (n = 13), and hypofractionated RT was performed in 3 patients. Most patients (n = 51, 63.8%) underwent delayed reconstruction, which involved implant replacement after tissue expander insertion. Only 29 patients (36.3%) underwent immediate reconstruction simultaneously with breast cancer surgery.

[RESULTS] The median postoperative follow-up was 39.9 months (range, 8.7-120.3 months). Complications occurred in 18 (22.5%); infection/necrosis (n = 8), leakage/rupture (n = 8), and capsular contracture (n = 2). Infection/necrosis is common in patients undergoing RT. Complications occurred in 4 patients (25.0%) who received RT and 14 (21.9%) who did not receive RT, and complications did not significantly increase with RT (P = 0.511). There was no overall difference in complications between the immediate (4 of 29) and delayed (14 of 51) reconstruction groups (P = 0.129). Nine patients underwent reoperation because of complications; 3 (18.8%) received RT and 6 (9.4%) did not receive RT. The reoperation rate did not increase significantly with RT (P = 0.254). There were 3 cases of recurrence, and patients who received RT had no recurrence.

[CONCLUSION] RT did not significantly increase the complication or reoperation rates if reconstructive surgery was performed using implants. Therefore, RT should be performed in patients at a high risk of recurrence.