Using own tissue in breast reconstruction less risky

Women who use their own tissue in breast reconstruction have fewer post-op complications than those who receive implants, Kiwi researchers have found.

In breast cancer patients here and around the world, reconstruction is commonly done after mastectomy.

A new study, just published in the New Zealand Medical Journal, looked at patients undergoing external beam radiotherapy, or XRT, who had had implant-based breast reconstruction (IBBR), and found they had greater complication rates post-surgery.

It analysed IBBR outcomes at Counties Manukau District Health Board between January 2012 and December 2013, when 77 procedures were performed in 53 patients.

In 2012, 11 patients had radiotherapy before or after their surgery, compared with five in 2013.

Radiotherapy was found to be strongly linked to higher reconstructive failure rates, while preoperative XRT was associated with more complications overall, including infections, wound healing problems and fluid collections, or seroma.

Over the two years, the number of IBBRs with any complication fell from 16 to 11 — or from 43.2 per cent to 27.5 per cent — while reconstructive failure fell from six to four, or 16.2 per cent to 10 per cent.

“Our study has found the complication rate in patients having implantbased breast reconstruction after radiotherapy for breast cancer treatment is very high,” said study leader Dr Michelle Locke, of the University of Auckland’s School of Medicine.

“We now encourage patients to use their own tissue, for example, from their abdomen, to reconstruct their breasts if they have had radiotherapy.

“We have shown a lower compli- cation rate in women who use their own tissue rather than implants.”

The researchers told patients with previous XRT or a high likelihood of requiring post-operative XRT of the high risk of complications of IBBR.

These patients were encouraged to favour autologous reconstructive options instead, where the patient’s own tissue is used.

The research team also included Dr William LE Malins of Newcastle University Medical School in Britain, Jia Le See of Auckland University, and Dr John Kenealy of Counties Manukau DHB. — Jamie Morton