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A 10-Year Experience with Mastectomy and Tissue Expander Placement to Facilitate Subsequent Radiation and Reconstruction

Background An integrated approach to skin sparing mastectomy with tissue expander placement followed by radiotherapy and delayed reconstruction was initiated in our institution in 2002. The purpose of this study was to assess the surgical outcomes of this strategy. Methods Between September 2002 and... Full description

Journal Title: Annals of surgical oncology 2017-08-01, Vol.24 (10), p.2965-2971
Main Author: Ayoub, Zeina
Other Authors: Strom, Eric A , Ovalle, Valentina , Perkins, George H , Woodward, Wendy A , Tereffe, Welela , Smith, Benjamin D , Shaitelman, Simona F , Stauder, Michael C , Hoffman, Karen E , DeSnyder, Sarah M , Garvey, Patrick B , Clemens, Mark W , Barcenas, Carlos H , Kuerer, Henry M , Kronowitz, Steven
Format: Electronic Article Electronic Article
Language: English
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Publisher: Cham: Springer International Publishing
ID: ISSN: 1068-9265
Link: https://www.ncbi.nlm.nih.gov/pubmed/28766219
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title: A 10-Year Experience with Mastectomy and Tissue Expander Placement to Facilitate Subsequent Radiation and Reconstruction
format: Article
creator:
  • Ayoub, Zeina
  • Strom, Eric A
  • Ovalle, Valentina
  • Perkins, George H
  • Woodward, Wendy A
  • Tereffe, Welela
  • Smith, Benjamin D
  • Shaitelman, Simona F
  • Stauder, Michael C
  • Hoffman, Karen E
  • DeSnyder, Sarah M
  • Garvey, Patrick B
  • Clemens, Mark W
  • Barcenas, Carlos H
  • Kuerer, Henry M
  • Kronowitz, Steven
subjects:
  • Adult
  • Aged
  • Breast cancer
  • Breast Implants
  • Breast Neoplasms - pathology
  • Breast Neoplasms - surgery
  • Breast Neoplasms - therapy
  • Breast Oncology
  • Carcinoma, Ductal, Breast - pathology
  • Carcinoma, Ductal, Breast - surgery
  • Carcinoma, Ductal, Breast - therapy
  • Carcinoma, Lobular - pathology
  • Carcinoma, Lobular - surgery
  • Carcinoma, Lobular - therapy
  • Cellulitis
  • Combined Modality Therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Mammaplasty
  • Mastectomy
  • Medical research
  • Medicine
  • Medicine & Public Health
  • Medicine, Experimental
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Recurrence, Local - diagnosis
  • Oncology
  • Prognosis
  • Radiation
  • Radiation therapy
  • Radiotherapy
  • Retrospective Studies
  • Skin
  • Surgery
  • Surgical Oncology
  • Survival
  • Survival Rate
  • Time Factors
  • Tissue Expansion
  • Tissue Expansion Devices
ispartof: Annals of surgical oncology, 2017-08-01, Vol.24 (10), p.2965-2971
description: Background An integrated approach to skin sparing mastectomy with tissue expander placement followed by radiotherapy and delayed reconstruction was initiated in our institution in 2002. The purpose of this study was to assess the surgical outcomes of this strategy. Methods Between September 2002 and August 2013, a total of 384 reconstructions had a tissue expander placed at the time of mastectomy and subsequently underwent radiotherapy. Rates and causes of tissue expander explantation before, during, and after radiotherapy, as well as tumor specific outcomes and reconstruction approaches, were collected. Results Median follow-up after diagnosis was 5.6 (range 1.3–13.4) years. In the study cohort, 364 patients (94.8%) had stage II–III breast cancer, and 7 patients (1.8%) had locally recurrent disease. The 5-year rates of actuarial locoregional control, disease-free survival, and overall survival were 99.2, 86.1, and 92.4%, respectively. The intended delayed-immediate reconstruction was subsequently completed in 325 of 384 mastectomies (84.6% of the study cohort). Of the remaining 59 tissue expanders, 1 was explanted before radiotherapy, 1 during radiotherapy, and 7 patients (1.8%) were lost to follow-up. Fifty patients (13.0%) required tissue expander explantation after radiation and before their planned final reconstruction, primarily due to cellulitis. Nonetheless, the cumulative rate of completed reconstructions was 89.6%. The median time from placement of the tissue expander until reconstruction was 12 (interquartile range 9–15) months. Conclusions Tissue expander placement at skin-sparing mastectomy in patients who require radiotherapy appears to be a viable strategy for combining reconstruction and radiotherapy.
language: eng
source:
identifier: ISSN: 1068-9265
fulltext: no_fulltext
issn:
  • 1068-9265
  • 1534-4681
url: Link


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titleA 10-Year Experience with Mastectomy and Tissue Expander Placement to Facilitate Subsequent Radiation and Reconstruction
creatorAyoub, Zeina ; Strom, Eric A ; Ovalle, Valentina ; Perkins, George H ; Woodward, Wendy A ; Tereffe, Welela ; Smith, Benjamin D ; Shaitelman, Simona F ; Stauder, Michael C ; Hoffman, Karen E ; DeSnyder, Sarah M ; Garvey, Patrick B ; Clemens, Mark W ; Barcenas, Carlos H ; Kuerer, Henry M ; Kronowitz, Steven
creatorcontribAyoub, Zeina ; Strom, Eric A ; Ovalle, Valentina ; Perkins, George H ; Woodward, Wendy A ; Tereffe, Welela ; Smith, Benjamin D ; Shaitelman, Simona F ; Stauder, Michael C ; Hoffman, Karen E ; DeSnyder, Sarah M ; Garvey, Patrick B ; Clemens, Mark W ; Barcenas, Carlos H ; Kuerer, Henry M ; Kronowitz, Steven
descriptionBackground An integrated approach to skin sparing mastectomy with tissue expander placement followed by radiotherapy and delayed reconstruction was initiated in our institution in 2002. The purpose of this study was to assess the surgical outcomes of this strategy. Methods Between September 2002 and August 2013, a total of 384 reconstructions had a tissue expander placed at the time of mastectomy and subsequently underwent radiotherapy. Rates and causes of tissue expander explantation before, during, and after radiotherapy, as well as tumor specific outcomes and reconstruction approaches, were collected. Results Median follow-up after diagnosis was 5.6 (range 1.3–13.4) years. In the study cohort, 364 patients (94.8%) had stage II–III breast cancer, and 7 patients (1.8%) had locally recurrent disease. The 5-year rates of actuarial locoregional control, disease-free survival, and overall survival were 99.2, 86.1, and 92.4%, respectively. The intended delayed-immediate reconstruction was subsequently completed in 325 of 384 mastectomies (84.6% of the study cohort). Of the remaining 59 tissue expanders, 1 was explanted before radiotherapy, 1 during radiotherapy, and 7 patients (1.8%) were lost to follow-up. Fifty patients (13.0%) required tissue expander explantation after radiation and before their planned final reconstruction, primarily due to cellulitis. Nonetheless, the cumulative rate of completed reconstructions was 89.6%. The median time from placement of the tissue expander until reconstruction was 12 (interquartile range 9–15) months. Conclusions Tissue expander placement at skin-sparing mastectomy in patients who require radiotherapy appears to be a viable strategy for combining reconstruction and radiotherapy.
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1EISSN: 1534-4681
2DOI: 10.1245/s10434-017-5956-6
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languageeng
publisherCham: Springer International Publishing
subjectAdult ; Aged ; Breast cancer ; Breast Implants ; Breast Neoplasms - pathology ; Breast Neoplasms - surgery ; Breast Neoplasms - therapy ; Breast Oncology ; Carcinoma, Ductal, Breast - pathology ; Carcinoma, Ductal, Breast - surgery ; Carcinoma, Ductal, Breast - therapy ; Carcinoma, Lobular - pathology ; Carcinoma, Lobular - surgery ; Carcinoma, Lobular - therapy ; Cellulitis ; Combined Modality Therapy ; Female ; Follow-Up Studies ; Humans ; Mammaplasty ; Mastectomy ; Medical research ; Medicine ; Medicine & Public Health ; Medicine, Experimental ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Recurrence, Local - diagnosis ; Oncology ; Prognosis ; Radiation ; Radiation therapy ; Radiotherapy ; Retrospective Studies ; Skin ; Surgery ; Surgical Oncology ; Survival ; Survival Rate ; Time Factors ; Tissue Expansion ; Tissue Expansion Devices
ispartofAnnals of surgical oncology, 2017-08-01, Vol.24 (10), p.2965-2971
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0Society of Surgical Oncology 2017
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0Ayoub, Zeina
1Strom, Eric A
2Ovalle, Valentina
3Perkins, George H
4Woodward, Wendy A
5Tereffe, Welela
6Smith, Benjamin D
7Shaitelman, Simona F
8Stauder, Michael C
9Hoffman, Karen E
10DeSnyder, Sarah M
11Garvey, Patrick B
12Clemens, Mark W
13Barcenas, Carlos H
14Kuerer, Henry M
15Kronowitz, Steven
title
0A 10-Year Experience with Mastectomy and Tissue Expander Placement to Facilitate Subsequent Radiation and Reconstruction
1Annals of surgical oncology
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0Ann Surg Oncol
1Ann Surg Oncol
descriptionBackground An integrated approach to skin sparing mastectomy with tissue expander placement followed by radiotherapy and delayed reconstruction was initiated in our institution in 2002. The purpose of this study was to assess the surgical outcomes of this strategy. Methods Between September 2002 and August 2013, a total of 384 reconstructions had a tissue expander placed at the time of mastectomy and subsequently underwent radiotherapy. Rates and causes of tissue expander explantation before, during, and after radiotherapy, as well as tumor specific outcomes and reconstruction approaches, were collected. Results Median follow-up after diagnosis was 5.6 (range 1.3–13.4) years. In the study cohort, 364 patients (94.8%) had stage II–III breast cancer, and 7 patients (1.8%) had locally recurrent disease. The 5-year rates of actuarial locoregional control, disease-free survival, and overall survival were 99.2, 86.1, and 92.4%, respectively. The intended delayed-immediate reconstruction was subsequently completed in 325 of 384 mastectomies (84.6% of the study cohort). Of the remaining 59 tissue expanders, 1 was explanted before radiotherapy, 1 during radiotherapy, and 7 patients (1.8%) were lost to follow-up. Fifty patients (13.0%) required tissue expander explantation after radiation and before their planned final reconstruction, primarily due to cellulitis. Nonetheless, the cumulative rate of completed reconstructions was 89.6%. The median time from placement of the tissue expander until reconstruction was 12 (interquartile range 9–15) months. Conclusions Tissue expander placement at skin-sparing mastectomy in patients who require radiotherapy appears to be a viable strategy for combining reconstruction and radiotherapy.
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2Breast cancer
3Breast Implants
4Breast Neoplasms - pathology
5Breast Neoplasms - surgery
6Breast Neoplasms - therapy
7Breast Oncology
8Carcinoma, Ductal, Breast - pathology
9Carcinoma, Ductal, Breast - surgery
10Carcinoma, Ductal, Breast - therapy
11Carcinoma, Lobular - pathology
12Carcinoma, Lobular - surgery
13Carcinoma, Lobular - therapy
14Cellulitis
15Combined Modality Therapy
16Female
17Follow-Up Studies
18Humans
19Mammaplasty
20Mastectomy
21Medical research
22Medicine
23Medicine & Public Health
24Medicine, Experimental
25Middle Aged
26Neoplasm Invasiveness
27Neoplasm Recurrence, Local - diagnosis
28Oncology
29Prognosis
30Radiation
31Radiation therapy
32Radiotherapy
33Retrospective Studies
34Skin
35Surgery
36Surgical Oncology
37Survival
38Survival Rate
39Time Factors
40Tissue Expansion
41Tissue Expansion Devices
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8Stauder, Michael C
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titleA 10-Year Experience with Mastectomy and Tissue Expander Placement to Facilitate Subsequent Radiation and Reconstruction
authorAyoub, Zeina ; Strom, Eric A ; Ovalle, Valentina ; Perkins, George H ; Woodward, Wendy A ; Tereffe, Welela ; Smith, Benjamin D ; Shaitelman, Simona F ; Stauder, Michael C ; Hoffman, Karen E ; DeSnyder, Sarah M ; Garvey, Patrick B ; Clemens, Mark W ; Barcenas, Carlos H ; Kuerer, Henry M ; Kronowitz, Steven
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1Aged
2Breast cancer
3Breast Implants
4Breast Neoplasms - pathology
5Breast Neoplasms - surgery
6Breast Neoplasms - therapy
7Breast Oncology
8Carcinoma, Ductal, Breast - pathology
9Carcinoma, Ductal, Breast - surgery
10Carcinoma, Ductal, Breast - therapy
11Carcinoma, Lobular - pathology
12Carcinoma, Lobular - surgery
13Carcinoma, Lobular - therapy
14Cellulitis
15Combined Modality Therapy
16Female
17Follow-Up Studies
18Humans
19Mammaplasty
20Mastectomy
21Medical research
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23Medicine & Public Health
24Medicine, Experimental
25Middle Aged
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29Prognosis
30Radiation
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32Radiotherapy
33Retrospective Studies
34Skin
35Surgery
36Surgical Oncology
37Survival
38Survival Rate
39Time Factors
40Tissue Expansion
41Tissue Expansion Devices
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3Perkins, George H
4Woodward, Wendy A
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8Stauder, Michael C
9Hoffman, Karen E
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12Clemens, Mark W
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1Strom, Eric A
2Ovalle, Valentina
3Perkins, George H
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7Shaitelman, Simona F
8Stauder, Michael C
9Hoffman, Karen E
10DeSnyder, Sarah M
11Garvey, Patrick B
12Clemens, Mark W
13Barcenas, Carlos H
14Kuerer, Henry M
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atitleA 10-Year Experience with Mastectomy and Tissue Expander Placement to Facilitate Subsequent Radiation and Reconstruction
jtitleAnnals of surgical oncology
stitleAnn Surg Oncol
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date2017-08-01
risdate2017
volume24
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pages2965-2971
issn1068-9265
eissn1534-4681
abstractBackground An integrated approach to skin sparing mastectomy with tissue expander placement followed by radiotherapy and delayed reconstruction was initiated in our institution in 2002. The purpose of this study was to assess the surgical outcomes of this strategy. Methods Between September 2002 and August 2013, a total of 384 reconstructions had a tissue expander placed at the time of mastectomy and subsequently underwent radiotherapy. Rates and causes of tissue expander explantation before, during, and after radiotherapy, as well as tumor specific outcomes and reconstruction approaches, were collected. Results Median follow-up after diagnosis was 5.6 (range 1.3–13.4) years. In the study cohort, 364 patients (94.8%) had stage II–III breast cancer, and 7 patients (1.8%) had locally recurrent disease. The 5-year rates of actuarial locoregional control, disease-free survival, and overall survival were 99.2, 86.1, and 92.4%, respectively. The intended delayed-immediate reconstruction was subsequently completed in 325 of 384 mastectomies (84.6% of the study cohort). Of the remaining 59 tissue expanders, 1 was explanted before radiotherapy, 1 during radiotherapy, and 7 patients (1.8%) were lost to follow-up. Fifty patients (13.0%) required tissue expander explantation after radiation and before their planned final reconstruction, primarily due to cellulitis. Nonetheless, the cumulative rate of completed reconstructions was 89.6%. The median time from placement of the tissue expander until reconstruction was 12 (interquartile range 9–15) months. Conclusions Tissue expander placement at skin-sparing mastectomy in patients who require radiotherapy appears to be a viable strategy for combining reconstruction and radiotherapy.
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pubSpringer International Publishing
pmid28766219
doi10.1245/s10434-017-5956-6