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Assessing the Utility of Post-Mastectomy Imaging after Breast Reconstruction.

Publication ,  Journal Article
Shammas, RL; Broadwater, G; Cason, RW; Glener, AD; Sergesketter, AR; Vernon, R; Le, E; Wickenheisser, VA; Marks, C; Hollenbeck, ST
Published in: Journal of the American College of Surgeons
April 2020

Few guidelines exist regarding surveillance and diagnostic imaging after breast reconstruction. This study investigated the influence of breast reconstruction on the frequency of post-mastectomy imaging, the relative utility of imaging, and its effect on overall and locoregional recurrence-free survival.A retrospective review identified breast cancer patients (n = 1,216) who underwent mastectomy with or without reconstruction. Logistic regression identified surgical and oncologic predictors of post-reconstruction imaging. Kaplan-Meier method determined the impact of post-reconstruction imaging on overall and locoregional recurrence-free survival.Overall, 662 (54.4%) patients underwent mastectomy only and 554 (45.6%) underwent breast reconstruction. Patients undergoing reconstruction were more likely to receive imaging compared with patients undergoing mastectomy only (n = 205, 37.0% vs n = 168, 25.4%; p < 0.0001); however, this difference was not statistically significant after adjusting for age and follow-up time (p = 0.16). Most radiographic studies were Breast Imaging Reporting and Data System (BI-RADS) 1 (n = 58, 30%) or 2 (n = 95, 49%) and were ordered by nonsurgical providers (n = 128, 63%). Post-reconstruction imaging did not influence overall or locoregional recurrence-free survival. The 5-year survival probabilities for breast reconstruction patients who underwent imaging for a palpable mass, surveillance, or who did not undergo imaging were 100%, 95% (95% CI 89% to 100%), and 96% (95% CI 94% to 99%), respectively. Post-reconstruction imaging was not a significant predictor of overall survival (hazard ratio [HR] 0.95; 95% CI 0.61 to 1.46; p = 0.30).The limited utility of routine post-reconstruction imaging should be reinforced when evaluating breast reconstruction patients. Multidisciplinary collaboration should be emphasized when attempting to distinguish benign postoperative findings from a malignant process to reduce unnecessary imaging and biopsy after breast reconstruction.

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Published In

Journal of the American College of Surgeons

DOI

EISSN

1879-1190

ISSN

1072-7515

Publication Date

April 2020

Volume

230

Issue

4

Start / End Page

605 / 614.e1

Related Subject Headings

  • Surgery
  • Retrospective Studies
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Mastectomy
  • Mammaplasty
  • Humans
  • Female
  • Disease-Free Survival
  • Breast Neoplasms
 

Citation

APA
Chicago
ICMJE
MLA
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Shammas, R. L., Broadwater, G., Cason, R. W., Glener, A. D., Sergesketter, A. R., Vernon, R., … Hollenbeck, S. T. (2020). Assessing the Utility of Post-Mastectomy Imaging after Breast Reconstruction. Journal of the American College of Surgeons, 230(4), 605-614.e1. https://doi.org/10.1016/j.jamcollsurg.2020.01.006
Shammas, Ronnie L., Gloria Broadwater, Roger W. Cason, Adam D. Glener, Amanda R. Sergesketter, Rebecca Vernon, Elliot Le, Victoria A. Wickenheisser, Caitlin Marks, and Scott T. Hollenbeck. “Assessing the Utility of Post-Mastectomy Imaging after Breast Reconstruction.Journal of the American College of Surgeons 230, no. 4 (April 2020): 605-614.e1. https://doi.org/10.1016/j.jamcollsurg.2020.01.006.
Shammas RL, Broadwater G, Cason RW, Glener AD, Sergesketter AR, Vernon R, et al. Assessing the Utility of Post-Mastectomy Imaging after Breast Reconstruction. Journal of the American College of Surgeons. 2020 Apr;230(4):605-614.e1.
Shammas, Ronnie L., et al. “Assessing the Utility of Post-Mastectomy Imaging after Breast Reconstruction.Journal of the American College of Surgeons, vol. 230, no. 4, Apr. 2020, pp. 605-614.e1. Epmc, doi:10.1016/j.jamcollsurg.2020.01.006.
Shammas RL, Broadwater G, Cason RW, Glener AD, Sergesketter AR, Vernon R, Le E, Wickenheisser VA, Marks C, Hollenbeck ST. Assessing the Utility of Post-Mastectomy Imaging after Breast Reconstruction. Journal of the American College of Surgeons. 2020 Apr;230(4):605-614.e1.
Journal cover image

Published In

Journal of the American College of Surgeons

DOI

EISSN

1879-1190

ISSN

1072-7515

Publication Date

April 2020

Volume

230

Issue

4

Start / End Page

605 / 614.e1

Related Subject Headings

  • Surgery
  • Retrospective Studies
  • Neoplasm Recurrence, Local
  • Middle Aged
  • Mastectomy
  • Mammaplasty
  • Humans
  • Female
  • Disease-Free Survival
  • Breast Neoplasms