Jornal de Ciência e Terapia Celular
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The Impact of Immediate Breast Reconstruction on the Technical Delivery of Postmastectomy Radiotherapy

Hany Mohammed Abdel Aziz, Atef Youssef Reyad, Tarek Hussein Kamel, Ahmed Hassan Abdel Aziz and Amit Bahl

Purpose: To quantify the impact of immediate reconstruction on radiotherapy planning after modified radical mastectomy & to study radiotherapy complications. Patients and methods: After surgery, patients submitted to adjuvant radiotherapy with irradiation technique assessment using a semi-quantitative score evaluating the design of radiation fields including five objectives: breadth of chest wall coverage, homogeneity, minimization of lung irradiation, avoidance of heart and Dmax. with assessment of radiation morbidity. Results: 30 patients were enrolled at Bristol Haematology & Oncology Centre (UK) and Oncology Department, Ain Shams University hospitals (Egypt) between November 2007 and November 2009, with a mean follow up of 14.4 months. 27 patients (90%) had Latissimus Dorsi flaps & 3 (10%) had TRAM flap. The analysis revealed compromise in 24% of the plans; all are moderate compromise. Reconstruction was noticed to compromise chest wall coverage in 27%. Dose homogeneity, Dmax. and minimizing irradiated lung and heart were not affected. Compromises were more common in left side while complications were grades 1 and 2 without major morbidities. Conclusion: Immediate reconstruction may limit treatment planning of postmastectomy radiotherapy, particularly in providing adequate chest wall coverage; so candidate patients for immediate reconstruction should be aware that the presence of the reconstructed breast could cause technical difficulties.