Immediate breast reconstruction has no impact on the oncologic outcomes of patients treated with post-mastectomy radiation therapy: a comparative analysis based on propensity score matching

2022 ◽  
Author(s):  
Nalee Kim ◽  
Haeyoung Kim ◽  
Won Park ◽  
Doo Ho Choi ◽  
Won Kyung Cho ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Comparative Analysis ◽  
Propensity Score ◽  
Breast Reconstruction ◽  
Propensity Score Matching ◽  
Immediate Breast Reconstruction ◽  
Oncologic Outcomes

Racial Disparity in Immediate Breast Reconstruction; a Gap That is not Closing

2021 ◽  
pp. 229255032110555
Author(s):  
Mahdi Malekpour ◽  
Sean Devitt ◽  
Joseph DeSantis ◽  
Christian Kauffman
Keyword(s):  
Propensity Score ◽  
Breast Reconstruction ◽  
Racial Disparity ◽  
Standard Of Care ◽  
Immediate Breast Reconstruction ◽  
P Value ◽  
National Cancer Database ◽  
Black Females ◽  
Black And White ◽  
Significant Difference

Background: Immediate breast reconstruction (IBR) is offered as part of the standard-of-care to females undergoing mastectomy. Racial disparity in IBR has been previously reported with a longstanding call for its elimination, though unknown if this goal is achieved. The aim of this study was to examine the current association between race and IBR and to investigate whether racial disparity is diminishing. Methods: Data was extracted from the National Cancer Database (NCDB) from 2004 to 2016. All variables in the database were controlled so that the comparison would be made solely between Black and White females. We also analyzed the trend in racial disparity to see if there has been a change from 2004 to 2016 after several calls for healthcare equality. Results: After propensity score matching, 69,084 White females were compared to 69,084 Black females. There was a statistically significant difference between the rate of IBR and race (23,386 [33.9%] in White females vs 20,850 [30.2%] in Black females, P-value  < .001). Despite a twofold increase in the rate of IBR in both White and Black females, a persistent gap of about 4% was observed over the study period, which translates to more than 2,500 Black females not receiving IBR. Conclusions: Using the NCDB database, a racial disparity was identified for IBR between White and Black females from 2004 and 2016. Unfortunately, the gap between the groups remained constant over this 13-year period.

The Impact of Radiation on Surgical Outcomes of Immediate Breast Reconstruction

2011 ◽  
Vol 77 (10) ◽  
pp. 1349-1352
Author(s):  
Tuan Tran ◽  
Tu Tran ◽  
Duncan Miles ◽  
Michael Hill ◽  
Sharon S. Lum
Keyword(s):  
Radiation Therapy ◽  
Breast Reconstruction ◽  
Surgical Outcomes ◽  
Immediate Breast Reconstruction ◽  
Partial Mastectomy ◽  
Breast Diseases ◽  
Adjuvant Radiation ◽  
Total Mastectomy ◽  
Reconstructive Operations ◽  
The Impact

We sought to determine the differences in surgical outcomes associated with adjuvant radiation versus no radiation in patients undergoing concurrent breast oncologic and reconstructive operations. A retrospective review of patients who underwent combined oncologic and plastic surgeries for breast diseases from January 2005 to June 2010 was compared for demographic factors and outcomes by receipt of radiation therapy. During the study period, 175 patients were identified; 25.7 per cent received radiation therapy. Mean patient age was 51 years and median follow-up was 355 days. Overall, 80.2 per cent of patients underwent mastectomy; 19.8 per cent partial mastectomy; 42.1 per cent autologous tissue reconstruction; and 54.8 per cent implant-based reconstruction. There were no significant differences between radiated and nonradiated patients in rates of overall or oncoplastic-specific complications. Lymphedema was the only complication seen more frequently in the radiated arm ( P = 0.03). In our series of carefully selected patients undergoing a variety of reconstructive techniques for repair of partial or total mastectomy defects, radiation was not associated with worse outcomes in patients undergoing immediate breast reconstruction. With careful collaboration among plastic surgeons, breast surgeons, and radiation oncologists, patients requiring breast surgery may safely be considered for reconstruction of partial or total mastectomy defects when adjuvant radiation is required.

The impact of radiotherapy, in addition to chemotherapy, on overall survival in the initial management of patients with newly diagnosed metastatic head and neck squamous cell carcinoma.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 6035-6035
Author(s):  
Sujith Baliga ◽  
Rafi Kabarriti ◽  
Nitin Ohri ◽  
Chandan Guha ◽  
Shalom Kalnicki ◽  
...  
Keyword(s):  
Overall Survival ◽  
Squamous Cell Carcinoma ◽  
Radiation Therapy ◽  
Propensity Score ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Propensity Score Matching ◽  
Squamous Cell ◽  
Prolonged Survival ◽  
Newly Diagnosed

6035 Background: The role of radiation therapy (RT) in the upfront management of patients with metastatic head and neck squamous cell carcinoma (HNSCC) is not clearly defined. In this study, we used the National Cancer Database (NCDB) to assess the association between RT use and overall survival (OS) for patients with metastatic HNSCC who received chemotherapy. Methods: We analyzed the NCDB to identify patients with newly diagnosed metastatic HNSCC from 2004-2013 who were treated with upfront chemotherapy. Associations between the use of RT and OS were evaluated using the Kaplan Meier method, univariate and multivariate cox regression, propensity score matching, and sequential landmark analysis. Survival outcomes were also compared for patients receiving a biologically effective dose (BED) ≥72 Gy10 and < 72 Gy10. Results: We identified 3,516 patients diagnosed with metastatic HNSCC who were treated with chemotherapy, of which 2,288 (65%) were also treated with RT. The median follow up was 11.9 months. The addition of RT to chemotherapy was associated with prolonged survival (median 13.6 v 11.3 months, logrank p < 0.001). On multivariate analysis, the use of RT remained associated with prolonged survival (HR = 0.71, 95% CI 0.61-0.82, p < 0.001). After propensity score matching, the addition of RT was associated with improved median survival (13.5 v 11.2 months) and 5-year (17% v 7%) OS compared to chemotherapy alone (log rank, p < 0·001). Landmark analyses limited to patients who survived at least 3, 6, and 12 months after diagnosis continued to demonstrate improved OS with the addition of RT. Among patients treated with RT, the use of RT schedules with a BED exceeding 72 Gy10 was associated with prolonged survival (median 18.0 versus 11.7 months, logrank p < 0.001). Conclusions: For patients with metastatic HNSCC, the addition of RT to chemotherapy was associated with improved OS in this population based study. These results provide rationale for prospective randomized trials to validate these findings and to determine the optimal radiation therapy dose/fractionation and treatment schedule for these patients.

1072 Tolerance of free T.R.A.M. flaps used in immediate breast reconstruction to radiation therapy

1995 ◽  
Vol 32 ◽  
pp. 258
Author(s):  
Robert P. Zimmerman ◽  
Susan M. Love ◽  
William W. Shaw ◽  
Clifford Ko ◽  
Rufus J. Mark ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Breast Reconstruction ◽  
Immediate Breast Reconstruction
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