ArticlePlastic and reconstructive surgery2016
The Impact of Radiation Therapy, Lymph Node Dissection, and Hormonal Therapy on Outcomes of Tissue Expander-Implant Exchange in Prosthetic Breast Reconstruction.
Article in Plastic and reconstructive surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it, 50 citations in OpenAlex.
- Pooled it
- Postmastectomy Radiation Therapy (PMRT) before and after 2-Stage Expander-Implant Breast Reconstruction: A Systematic Review.Medicina (Kaunas, Lithuania) · 2019Pooled it
- Direct-to-implant breast reconstruction: retrospective analysis of 91 consecutive cases.Updates in surgery · 2025Article
- Breast Reconstruction following Mastectomy for Breast Cancer or Prophylactic Mastectomy: Therapeutic Options and Results.Life (Basel, Switzerland) · 2024Review
- Breast reconstruction: Review of current autologous and implant-based techniques and long-term oncologic outcome.World journal of clinical cases · 2023Review
- Article
- The Impact of Postoperative Radiotherapy on Dietary Function of Head and Neck Cancer Patients after Pharyngoesophageal Reconstruction with Free Jejunal Flap.Journal of clinical medicine · 2022Article
- Analysis of factors that affect drainage volume after expander-based breast reconstruction.Archives of plastic surgery · 2020Article
- Outcomes Utilizing Inspira Implants in Primary Aesthetic and Reconstructive Surgery.Plastic and reconstructive surgery · 2019Review
- Immediate Implant-based Breast Reconstruction with Acellular Dermal Matrix Compared with Tissue-expander Breast Reconstruction: Rate of Infection.Plastic and reconstructive surgery. Global open · 2018Article
- Comparison of Wound Complications After Immediate, Delayed, and Secondary Breast Reconstruction Procedures.JAMA surgery · 2017Article
- Treatment of Post-Latissimus Dorsi Flap Breast Reconstruction Pain With Continuous Paravertebral Nerve Blocks: A Retrospective Review.Anesthesiology and pain medicine · 2016Article
- Impact of different type of cancer treatment on the effectiveness of breast reconstruction.Gland surgery · 2016Article
- Two-stage implant based breast reconstruction: should we always exchange the tissue expander for an implant right away?Gland surgery · 2016Article
- Predictive Factors for Drainage Volume after Expander-based Breast Reconstruction.Plastic and reconstructive surgery. Global open · 2016Article
- Oncoplastic Breast Surgery: What, When and for Whom?Current breast cancer reportsReview
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Authors and funding
9 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTotal skin-sparing mastectomy, with preservation of the nipple-areola complex, must account for adjuvant medical and surgical treatments for cancer. The authors assessed risk factors for complications after second-stage tissue expander-implant exchange.
methodsThe authors reviewed all institutional total skin-sparing mastectomy cases that had completed tissue expander-implant exchange with at least 3 months of follow-up. They developed multivariate generalized estimating equation models to obtain adjusted relative risks of radiation therapy, type of lymph node dissection, and hormonal therapy in relation to postoperative complications.
resultsThe authors performed 776 cases in 489 patients, with a median follow-up of 26 months (interquartile range, 10 to 48 months). Radiation therapy was associated with increased wound breakdown risk [relative risk (RR), 3.3; 95 percent CI, 2.0 to 5.7]; infections requiring oral antibiotics (RR, 2.2; 95 percent CI, 1.31 to 3.6), intravenous antibiotics (RR, 6.4; 95 percent CI, 3.9 to 10.7), or procedures (RR, 8.9; 95 percent CI, 4.5 to 17.5); implant exposure (RR, 3.9; 95 percent CI, 1.86 to 8.3); and implant loss (RR, 4.2; 95 percent CI, 2.4 to 7.4). Axillary lymph node dissection was associated with an increased risk of implant loss (RR, 2.0; 95 percent CI, 1.11 to 3.7) relative to sentinel lymph node biopsy.
conclusionsAxillary lymph node dissection increases the risk of implant loss compared with sentinel lymph node biopsy, independent of radiation therapy. Patients who require axillary lymph node dissection may be encouraged to undergo breast conservation or autologous reconstruction when possible. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
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