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• W2060353723 abstract "Sir:FigureWe read with great interest the article by Cordeiro et al. entitled “Immediate Tissue Expander/Implant Breast Reconstruction after Salvage Mastectomy for Cancer Recurrence following Lumpectomy/Irradiation.”1 In their work, the authors analyze early complications and long-term outcomes in patients undergoing salvage mastectomy and immediate tissue expander/implant reconstruction for cancer recurrence following breast conservation therapy (lumpectomy/irradiation). Radiation therapy is known to induce long-term detrimental effects on wound healing and tissue quality and therefore has been advocated to be associated with increased rates of complications and dissatisfaction in breast reconstruction. Actually, most of the studies in this field enrolled groups of patients heterogeneous for timing (preoperative or postoperative) and type of radiation therapy, surgical technique, and time intervals between demolitive surgery, radiotherapy, and reconstruction. Cordeiro et al. analyzed data from 1699 women, of whom 121 had prior lumpectomy and radiation therapy, demonstrating that carefully selected patients who have had prior breast conservation therapy and who require salvage mastectomy can successfully complete postmastectomy tissue expander/implant reconstruction. The rate of early complications in this patient group is higher than in the nonirradiated cohort but remains acceptable. We congratulate the authors for their work, which is the most consistent ever published for number of patients; however, there is something we would like to point out. The authors state that the generalized conclusions made by previous articles do not apply to the specific groups of patients being reviewed in this article. On the contrary, in April of 2009, we published an article entitled “Implant Breast Reconstruction after Salvage Mastectomy in Previously Irradiated Patients,”2 in which we evaluated exactly the influence of previous radiotherapy on two-stage breast reconstruction. In our study, we enrolled and grouped women with analogous time of radiation therapy who underwent the same demolitive and reconstructive procedures and compared the types and rates of complications with a control group of patients who underwent primary radical mastectomy without radiotherapy exactly as the authors did in their article. In this debated field of reconstructive surgery, we believe that our experience, suffering from very low patient numbers, must be taken into consideration as the first article that compared two specific groups of patients. However, this article must be consider of great interest and scientific value, representing the most important series ever published on implant reconstruction in patients with previous chest wall irradiation. Barbara Cagli, M.D. Paolo Persichetti, M.D., Ph.D. Plastic Surgery Unit, Campus Bio-Medico University of Rome, Rome, Italy DISCLOSURE The authors have no commercial associations that might pose or create a conflict of interest with information presented in this communication. No intramural or extramural funding supported any aspect of this work." @default.
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• W2060353723 date "2012-09-01" @default.
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• W2060353723 title "Immediate Tissue Expander/Implant Breast Reconstruction after Salvage Mastectomy for Cancer Recurrence following Lumpectomy/Irradiation" @default.
• W2060353723 doi "https://doi.org/10.1097/prs.0b013e31825dc422" @default.
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