Nipple Areola Reconstruction in the Irradiated Breast ...



Title: Nipple Areola Reconstruction Following Chest Wall Irradiation for Breast Cancer: Is it Safe?

Authors: Duc T. Bui, MD, Ernest S. Chiu, MD, Lawrence B. Draper, BA, Babak J. Mehrara, MD, Peter G. Cordeiro, MD, Joseph J. Disa, MD

Background: Nipple areola complex reconstruction (NAR) is an important final step in breast reconstruction. Radiation therapy (RT) is considered by some to be a contraindication to NAR particularly in patients with implant reconstruction. Although there are several reports of the increased risk of complications between adjuvant RT and implant breast reconstruction,1,2 little data exist for NAR in this setting. The objective of this study was, therefore, to examine our experience with NAR in patients who were reconstructed with implants and who had a history of RT.

Methods: A retrospective review was performed on all patients who underwent NAR after breast reconstruction with tissue expanders and implants at a single cancer center over a 6-year period (1997-2003). All patients who had a history of RT (either preoperatively or postoperatively) were identified and their charts as well as a prospectively maintained database were analyzed with respect to: the timing of RT, interval of time to NAR after RT, interval of time to NAR after implant placement, surgical technique, and postoperative complications.

Results: During the study period, only 13% (28/222) of patients with a history of RT underwent NAR after implant reconstruction. In contrast, 36% of similarly reconstructed patients (616/1726) who were not treated with RT underwent NAR (p ................
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