Andrea Vittorio Emanuele Lisa, Marzia Salgarello, Alessandra Huscher, Fabio Corsi, Daniele Piovani, Federica Rubbino, Stefania Andreoletti, Giovanni Papa, Francesco Klinger, Corrado Tinterri, Alberto Testori, Marta Scorsetti, Paolo Veronesi, Maria Cristina Leonardi, Mario Rietjens, Umberto Cortinovis, Valeria Summo, Emanuele Rampino Cordaro, Pier Camillo Parodi, Paolo Persichetti, Mauro Barone, Giorgio De Santis, Matteo Murolo, Michele Riccio, Angelica Aquinati, Francesco Cavaliere, Nicola Vaia, Giulia Pagura, Erica Dalla Venezia, Franco Bassetto, Vincenzo Vindigni, Luigi Ciuffreda, Maria Alessandra Bocchiotti, Alberto Sciarillo, Nadia Renzi, Graziano Meneghini, Tajna Kraljic, Andrea Loreti, Lucio Fortunato, Valentina Pino, Valeriano Vinci, Marco Klinger
{"title":"辅助放疗对一期和二期人工乳房重建及自体乳房重建的影响：意大利 18 家乳腺中心的多中心研究。","authors":"Andrea Vittorio Emanuele Lisa, Marzia Salgarello, Alessandra Huscher, Fabio Corsi, Daniele Piovani, Federica Rubbino, Stefania Andreoletti, Giovanni Papa, Francesco Klinger, Corrado Tinterri, Alberto Testori, Marta Scorsetti, Paolo Veronesi, Maria Cristina Leonardi, Mario Rietjens, Umberto Cortinovis, Valeria Summo, Emanuele Rampino Cordaro, Pier Camillo Parodi, Paolo Persichetti, Mauro Barone, Giorgio De Santis, Matteo Murolo, Michele Riccio, Angelica Aquinati, Francesco Cavaliere, Nicola Vaia, Giulia Pagura, Erica Dalla Venezia, Franco Bassetto, Vincenzo Vindigni, Luigi Ciuffreda, Maria Alessandra Bocchiotti, Alberto Sciarillo, Nadia Renzi, Graziano Meneghini, Tajna Kraljic, Andrea Loreti, Lucio Fortunato, Valentina Pino, Valeriano Vinci, Marco Klinger","doi":"10.1155/2023/6688466","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>In modern breast cancer treatment, a growing role has been observed for breast reconstruction together with an increase in clinical indications for postmastectomy radiotherapy (PMRT). Choosing the optimum type of reconstructive technique is a clinical challenge. We therefore conducted a national multicenter study to analyze the impact of PMRT on breast reconstruction.</p><p><strong>Methods: </strong>We conducted a retrospective case-control multicenter study on women undergoing breast reconstruction. Data were collected from 18 Italian Breast Centres and stored in a cumulative database which included the following: autologous reconstruction, direct-to-implant (DTI), and tissue expander/immediate (TE/I). For all patients, we described complications and surgical endpoints to complications such as reconstruction failure, explant, change in type of reconstruction, and reintervention.</p><p><strong>Results: </strong>From 2001 to April 2020, 3116 patients were evaluated. The risk for any complication was significantly increased in patients receiving PMRT (aOR, 1.73; 95% CI, 1.33-2.24; <i>p</i> < 0.001). PMRT was associated with a significant increase in the risk of capsular contracture in the DTI and TE/I groups (aOR, 2.24; 95% CI, 1.57-3.20; <i>p</i> < 0.001). Comparing type of procedures, the risk of failure (aOR, 1.82; 95% CI, 1.06-3.12, <i>p</i>=0.030), explant (aOR, 3.34; 95% CI, 3.85-7.83, <i>p</i> < 0.001), and severe complications (aOR, 2.54; 95% CI, 1.88-3.43, <i>p</i> < 0.001) were significantly higher in the group undergoing DTI reconstruction as compared to TE/I reconstruction.</p><p><strong>Conclusion: </strong>Our study confirms that autologous reconstruction is the procedure least impacted by PMRT, while DTI appears to be the most impacted by PMRT, when compared with TE/I which shows a lower rate of explant and reconstruction failure. The trial is registered with NCT04783818, and the date of registration is 1 March, 2021, retrospectively registered.</p>","PeriodicalId":56326,"journal":{"name":"Breast Journal","volume":"2023 ","pages":"6688466"},"PeriodicalIF":1.9000,"publicationDate":"2023-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10188256/pdf/","citationCount":"0","resultStr":"{\"title\":\"The Effect of Adjuvant Radiotherapy on One- and Two-Stage Prosthetic Breast Reconstruction and on Autologous Reconstruction: A Multicenter Italian Study among 18 Senonetwork Breast Centres.\",\"authors\":\"Andrea Vittorio Emanuele Lisa, Marzia Salgarello, Alessandra Huscher, Fabio Corsi, Daniele Piovani, Federica Rubbino, Stefania Andreoletti, Giovanni Papa, Francesco Klinger, Corrado Tinterri, Alberto Testori, Marta Scorsetti, Paolo Veronesi, Maria Cristina Leonardi, Mario Rietjens, Umberto Cortinovis, Valeria Summo, Emanuele Rampino Cordaro, Pier Camillo Parodi, Paolo Persichetti, Mauro Barone, Giorgio De Santis, Matteo Murolo, Michele Riccio, Angelica Aquinati, Francesco Cavaliere, Nicola Vaia, Giulia Pagura, Erica Dalla Venezia, Franco Bassetto, Vincenzo Vindigni, Luigi Ciuffreda, Maria Alessandra Bocchiotti, Alberto Sciarillo, Nadia Renzi, Graziano Meneghini, Tajna Kraljic, Andrea Loreti, Lucio Fortunato, Valentina Pino, Valeriano Vinci, Marco Klinger\",\"doi\":\"10.1155/2023/6688466\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>In modern breast cancer treatment, a growing role has been observed for breast reconstruction together with an increase in clinical indications for postmastectomy radiotherapy (PMRT). Choosing the optimum type of reconstructive technique is a clinical challenge. We therefore conducted a national multicenter study to analyze the impact of PMRT on breast reconstruction.</p><p><strong>Methods: </strong>We conducted a retrospective case-control multicenter study on women undergoing breast reconstruction. Data were collected from 18 Italian Breast Centres and stored in a cumulative database which included the following: autologous reconstruction, direct-to-implant (DTI), and tissue expander/immediate (TE/I). For all patients, we described complications and surgical endpoints to complications such as reconstruction failure, explant, change in type of reconstruction, and reintervention.</p><p><strong>Results: </strong>From 2001 to April 2020, 3116 patients were evaluated. The risk for any complication was significantly increased in patients receiving PMRT (aOR, 1.73; 95% CI, 1.33-2.24; <i>p</i> < 0.001). PMRT was associated with a significant increase in the risk of capsular contracture in the DTI and TE/I groups (aOR, 2.24; 95% CI, 1.57-3.20; <i>p</i> < 0.001). Comparing type of procedures, the risk of failure (aOR, 1.82; 95% CI, 1.06-3.12, <i>p</i>=0.030), explant (aOR, 3.34; 95% CI, 3.85-7.83, <i>p</i> < 0.001), and severe complications (aOR, 2.54; 95% CI, 1.88-3.43, <i>p</i> < 0.001) were significantly higher in the group undergoing DTI reconstruction as compared to TE/I reconstruction.</p><p><strong>Conclusion: </strong>Our study confirms that autologous reconstruction is the procedure least impacted by PMRT, while DTI appears to be the most impacted by PMRT, when compared with TE/I which shows a lower rate of explant and reconstruction failure. The trial is registered with NCT04783818, and the date of registration is 1 March, 2021, retrospectively registered.</p>\",\"PeriodicalId\":56326,\"journal\":{\"name\":\"Breast Journal\",\"volume\":\"2023 \",\"pages\":\"6688466\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2023-05-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10188256/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Breast Journal\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1155/2023/6688466\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q3\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Breast Journal","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1155/2023/6688466","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
The Effect of Adjuvant Radiotherapy on One- and Two-Stage Prosthetic Breast Reconstruction and on Autologous Reconstruction: A Multicenter Italian Study among 18 Senonetwork Breast Centres.
Purpose: In modern breast cancer treatment, a growing role has been observed for breast reconstruction together with an increase in clinical indications for postmastectomy radiotherapy (PMRT). Choosing the optimum type of reconstructive technique is a clinical challenge. We therefore conducted a national multicenter study to analyze the impact of PMRT on breast reconstruction.
Methods: We conducted a retrospective case-control multicenter study on women undergoing breast reconstruction. Data were collected from 18 Italian Breast Centres and stored in a cumulative database which included the following: autologous reconstruction, direct-to-implant (DTI), and tissue expander/immediate (TE/I). For all patients, we described complications and surgical endpoints to complications such as reconstruction failure, explant, change in type of reconstruction, and reintervention.
Results: From 2001 to April 2020, 3116 patients were evaluated. The risk for any complication was significantly increased in patients receiving PMRT (aOR, 1.73; 95% CI, 1.33-2.24; p < 0.001). PMRT was associated with a significant increase in the risk of capsular contracture in the DTI and TE/I groups (aOR, 2.24; 95% CI, 1.57-3.20; p < 0.001). Comparing type of procedures, the risk of failure (aOR, 1.82; 95% CI, 1.06-3.12, p=0.030), explant (aOR, 3.34; 95% CI, 3.85-7.83, p < 0.001), and severe complications (aOR, 2.54; 95% CI, 1.88-3.43, p < 0.001) were significantly higher in the group undergoing DTI reconstruction as compared to TE/I reconstruction.
Conclusion: Our study confirms that autologous reconstruction is the procedure least impacted by PMRT, while DTI appears to be the most impacted by PMRT, when compared with TE/I which shows a lower rate of explant and reconstruction failure. The trial is registered with NCT04783818, and the date of registration is 1 March, 2021, retrospectively registered.
期刊介绍：
The Breast Journal is the first comprehensive, multidisciplinary source devoted exclusively to all facets of research, diagnosis, and treatment of breast disease. The Breast Journal encompasses the latest news and technologies from the many medical specialties concerned with breast disease care in order to address the disease within the context of an integrated breast health care. This editorial philosophy recognizes the special social, sexual, and psychological considerations that distinguish cancer, and breast cancer in particular, from other serious diseases. Topics specifically within the scope of The Breast Journal include:
Risk Factors
Prevention
Early Detection
Diagnosis and Therapy
Psychological Issues
Quality of Life
Biology of Breast Cancer.
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