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Is Tissue Expansion Worth It? Comparative Outcomes of Skin-preserving versus Delayed Autologous Breast Reconstruction.

Publication ,  Journal Article
Phillips, BT; Mercier-Couture, G; Xue, AS; Chu, CK; Schaverien, MV; Liu, J; Garvey, PB; Baumann, DP; Butler, CE; Largo, RD
Published in: Plast Reconstr Surg Glob Open
November 2020

UNLABELLED: The requirement for postmastectomy radiation therapy (PMRT) at the time of mastectomy is often unknown. Autologous reconstruction is preferred in the setting of radiotherapy by providing healthy vascularized tissue to the chest. To maximize mastectomy skin preservation, tissue expander (TE) placement maintains the breast pocket until definitive reconstruction. This study aims to compare outcomes of skin-preserving delayed versus standard delayed autologous breast reconstruction in the setting of PMRT. METHODS: A retrospective review of a prospective database was performed of two patient cohorts at a single center between 2006 and 2016. Inclusion criteria were locally advanced breast cancer patients who completed PMRT and free autologous reconstruction. Primary outcomes were major intraoperative and postoperative TE and flap complications. RESULTS: Over 10 years, 241 patients underwent mastectomy and PMRT. Standard delayed autologous breast reconstruction was performed in 131 breasts (non-TE group). Skin-preserving delayed autologous reconstruction was performed in 113 breasts (TE group). The TE group was associated with a higher incidence of intraoperative complications during flap reconstruction (P = 0.002) and had a higher venous thrombosis incidence than the non-TE cohort (P = 0.007). Other major postoperative complications were not significantly different between the two groups. TE patients had 7.5 times higher risk of intraoperative complications and an 18.6% TE loss rate. CONCLUSIONS: We identified higher intraoperative flap complications and a high rate of TE loss in patients who underwent skin-preserving delayed autologous breast reconstruction. The benefit of mastectomy skin preservation needs to be weighed against the increased risk of TE loss and higher rates of flap thrombosis.

Duke Scholars

Published In

Plast Reconstr Surg Glob Open

DOI

ISSN

2169-7574

Publication Date

November 2020

Volume

8

Issue

11

Start / End Page

e3217

Location

United States

Related Subject Headings

  • 3213 Paediatrics
  • 3211 Oncology and carcinogenesis
  • 3202 Clinical sciences
 

Citation

APA
Chicago
ICMJE
MLA
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Phillips, B. T., Mercier-Couture, G., Xue, A. S., Chu, C. K., Schaverien, M. V., Liu, J., … Largo, R. D. (2020). Is Tissue Expansion Worth It? Comparative Outcomes of Skin-preserving versus Delayed Autologous Breast Reconstruction. Plast Reconstr Surg Glob Open, 8(11), e3217. https://doi.org/10.1097/GOX.0000000000003217
Phillips, Brett T., Genevieve Mercier-Couture, Amy S. Xue, Carrie K. Chu, Mark V. Schaverien, Jun Liu, Patrick B. Garvey, Donald P. Baumann, Charles E. Butler, and Rene D. Largo. “Is Tissue Expansion Worth It? Comparative Outcomes of Skin-preserving versus Delayed Autologous Breast Reconstruction.Plast Reconstr Surg Glob Open 8, no. 11 (November 2020): e3217. https://doi.org/10.1097/GOX.0000000000003217.
Phillips BT, Mercier-Couture G, Xue AS, Chu CK, Schaverien MV, Liu J, et al. Is Tissue Expansion Worth It? Comparative Outcomes of Skin-preserving versus Delayed Autologous Breast Reconstruction. Plast Reconstr Surg Glob Open. 2020 Nov;8(11):e3217.
Phillips, Brett T., et al. “Is Tissue Expansion Worth It? Comparative Outcomes of Skin-preserving versus Delayed Autologous Breast Reconstruction.Plast Reconstr Surg Glob Open, vol. 8, no. 11, Nov. 2020, p. e3217. Pubmed, doi:10.1097/GOX.0000000000003217.
Phillips BT, Mercier-Couture G, Xue AS, Chu CK, Schaverien MV, Liu J, Garvey PB, Baumann DP, Butler CE, Largo RD. Is Tissue Expansion Worth It? Comparative Outcomes of Skin-preserving versus Delayed Autologous Breast Reconstruction. Plast Reconstr Surg Glob Open. 2020 Nov;8(11):e3217.

Published In

Plast Reconstr Surg Glob Open

DOI

ISSN

2169-7574

Publication Date

November 2020

Volume

8

Issue

11

Start / End Page

e3217

Location

United States

Related Subject Headings

  • 3213 Paediatrics
  • 3211 Oncology and carcinogenesis
  • 3202 Clinical sciences