Rekonstruktives Vorgehen zum Brustwiederaufbau bei geplanter Bestrahlung

Zusammenfassung

Einleitung Die ideale zeitliche und technische Vorgehensweise zur Brustrekonstruktion bei geplanter Radiatio nach vorausgegangener Mastektomie (Postmastektomie Radiotherapie; PMRT) wird weiterhin kontrovers diskutiert.

Methoden Die Autoren analysierten die MEDLINE Datenbank PubMed hinsichtlich Studien, die PMRT und Brustrekonstruktion thematisierten. Die Kernaussagen dieser Studien wurden extrahiert und zusammengefasst.

Ergebnisse Ein Implantat-basiertes rekonstruktives Vorgehen stellt die am wenigsten invasive zeitnahe Variante in einem PMRT-Setting dar und resultiert in einem sofortigen Brustwiederaufbau. Eine Rekonstruktion mit einem zweizeitigen Vorgehen durch ein Expander-Implantat bzw. Expander-Implantat-autologes Vorgehen ermöglicht gute bis exzellente Resultate. Verglichen mit der heterologen Vorgehensweise, resultieren autologe Rekonstruktionsverfahren in einer besseren Lebensqualität, haptisch-sensorischen Vorteilen und sind in der Regel mit einer geringeren Komplikationsrate assoziiert. Eine PMRT nach bereits durchgeführter autologer Rekonstruktion kann mit negativen ästhetischen Ergebnissen assoziiert sein. Ein delayed autologes Vorgehen kann vorteilhaft sein und sollte insbesondere bei Hochrisikopatientinnen favorisiert werden.

Zusammenfassung Faktoren, die in die sorgfältige Planung einer Brustrekonstruktion bei notwendiger PMRT einbezogen werden müssen, sind chirurgischer und ästhetischer Natur, beinhalten die Lebensqualität sowie Charakteristika, Wunsch und Erwartungshaltung der jeweiligen Patientin. Die autologe Rekonstruktion sollte im Idealfall nach der PMRT stattfinden, um potentiell negativ beeinträchtigende Einflüsse auf das eigengewebliche Resultat zu vermeiden. Falls eine PMRT wahrscheinlich ist, aber möglicherweise nicht notwendig wird, kann eine immediate-delayed Vorgehensweise vorteilhaft sein.

Abstract

Introduction The ideal technical and chronological approach of breast reconstruction in case of planned radiotherapy after mastectomy (post-mastectomy radiotherapy, PMRT) continues to be controversially discussed.

Methods The authors analysed the MEDLINE Database PubMed for relevant studies concerning PMRT and breast reconstruction. The main theses from these publications were extracted and summarised.

Results An implant-based approach is the least invasive technique for immediate breast-mound formation in a PMRT setting. Reconstruction in a PMRT setting with a two-stage expander-implant technique or expander-implant-autologous procedure can provide good to excellent cosmetic outcomes. In contrast to the implant-based approach, autologous reconstruction methods provide an improved quality of life as well as haptic and sensory advantages and are usually associated with lower complication rates. PMRT after autologous reconstruction can have a negative impact on the autologous tissue. A delayed autologous approach can be advantageous and should be generally favoured in high-risk patients.

Conclusion Factors influencing a meticulous planning of breast reconstruction including PMRT are surgical, aesthetic and patient characteristics, quality of life, preference and expectation. Ideally, PMRT is completed before autologous reconstruction to avoid radiation-associated side-effects on the final reconstructive result. If PMRT is likely, but potentially not necessary, an immediate-delayed procedure may be of advantage.

Schlüsselwörter

Postmastektomie Radiotherapie - PMRT - DIEP Lappenplastik - Radiatio - DIEP flap - radiation - radiotherapy - autologous breast reconstruction - autologe Brustrekonstruktion - post-mastectomy radiotherapy

Publication History

Received: 01 December 2021

Accepted: 29 March 2022

Article published online:
21 June 2022

• Literatur

• 1 Fahad Ullah M. Breast Cancer: Current Perspectives on the Disease Status. Adv Exp Med Biol 2019; 1152: 51-64 DOI: 10.1007/978-3-030-20301-6_4.
• 2 Winters S, Martin C, Murphy D. et al. Breast Cancer Epidemiology, Prevention, and Screening. Prog Mol Biol Transl Sci 2017; 151: 1-32 DOI: 10.1016/BS.PMBTS.2017.07.002.
• 3 AWMF – Leitlinie interdisziplinäre Behandlung nach Mamma-Ca. Interdisziplinäre S3-Leitlinie für die Früherkennung , Diagnostik, Therapie und Nachsorge des Mammakarzinoms. 2021; 4.4: 152. Im Internet: https://www.awmf.org/uploads/tx_szleitlinien/032-045OLl_S3_Mammakarzinom_2021-07.pdf
• 4 Bradley JA, Mendenhall NP. Novel Radiotherapy Techniques for Breast Cancer. Annu Rev Med 2018; 69: 277-288 DOI: 10.1146/ANNUREV-MED-042716-103422.
• 5 Lipsett A, Barrett S, Haruna F. et al. The impact of exercise during adjuvant radiotherapy for breast cancer on fatigue and quality of life: A systematic review and meta-analysis. Breast 2017; 32: 144-155 DOI: 10.1016/J.BREAST.2017.02.002.
• 6 Coles CE, Griffin CL, Kirby AM. et al. Partial-breast radiotherapy after breast conservation surgery for patients with early breast cancer (UK IMPORT LOW trial): 5-year results from a multicentre, randomised, controlled, phase 3, non-inferiority trial. Lancet (London, England) 2017; 390: 1048-1060 DOI: 10.1016/S0140-6736(17)31145-5.
• 7 Krug D, Baumann R, Budach W. et al. Individualization of post-mastectomy radiotherapy and regional nodal irradiation based on treatment response after neoadjuvant chemotherapy for breast cancer : A systematic review. Strahlenther Onkol 2018; 194: 607-618 DOI: 10.1007/S00066-018-1270-X.
• 8 Vicini FA, Cecchini RS, White JR. et al. Long-term primary results of accelerated partial breast irradiation after breast-conserving surgery for early-stage breast cancer: a randomised, phase 3, equivalence trial. Lancet (London, England) 2019; 394: 2155-2164 DOI: 10.1016/S0140-6736(19)32514-0.
• 9 Sjöström M, Lundstedt D, Hartman L. et al. Response to Radiotherapy After Breast-Conserving Surgery in Different Breast Cancer Subtypes in the Swedish Breast Cancer Group 91 Radiotherapy Randomized Clinical Trial. J Clin Oncol 2017; 35: 3222-3229 DOI: 10.1200/JCO.2017.72.7263.
• 10 McGale P, Taylor C, Correa C. et al. Effect of radiotherapy after mastectomy and axillary surgery on 10-year recurrence and 20-year breast cancer mortality: meta-analysis of individual patient data for 8135 women in 22 randomised trials. Lancet (London, England) 2014; 383: 2127-2135 DOI: 10.1016/S0140-6736(14)60488-8.
• 11 Ryan JL. Ionizing radiation: the good, the bad, and the ugly. J Invest Dermatol 2012; 132: 985-993 DOI: 10.1038/JID.2011.411.
• 12 Porock D, Kristjanson L. Skin reactions during radiotherapy for breast cancer: the use and impact of topical agents and dressings. Eur J Cancer Care (Engl) 1999; 8: 143-153 DOI: 10.1046/J.1365-2354.1999.00153.X.
• 13 Whelan TJ, Olivotto IA, Levine MN. Regional Nodal Irradiation in Early-Stage Breast Cancer. N Engl J Med 2015; 373: 1877-1880 DOI: 10.1056/nejmc1510505.
• 14 Fosnot J, Fischer JP, Smartt JM. et al. Does previous chest wall irradiation increase vascular complications in free autologous breast reconstruction?. Plast Reconstr Surg 2011; 127: 496-504 DOI: 10.1097/PRS.0b013e3181fed560.
• 15 Cordeiro PG, Albornoz CR, McCormick B. et al. The impact of postmastectomy radiotherapy on two-stage implant breast reconstruction: an analysis of long-term surgical outcomes, aesthetic results, and satisfaction over 13 years. Plast Reconstr Surg 2014; 134: 588-595 DOI: 10.1097/PRS.0000000000000523.
• 16 Tuttle TM, Habermann EB, Grund EH. et al. Increasing use of contralateral prophylactic mastectomy for breast cancer patients: a trend toward more aggressive surgical treatment. J Clin Oncol 2007; 25: 5203-5209 DOI: 10.1200/JCO.2007.12.3141.
• 17 Jagsi R, Momoh AO, Qi J. et al. Impact of Radiotherapy on Complications and Patient-Reported Outcomes after Breast Reconstruction. J Natl Cancer Inst 2018; 110 DOI: 10.1093/jnci/djx148.
• 18 Milligan MG, Zieminski S, Johnson A. et al. Target coverage and cardiopulmonary sparing with the updated ESTRO-ACROP contouring guidelines for postmastectomy radiation therapy after breast reconstruction: a treatment planning study using VMAT and proton PBS techniques. Acta Oncol 2021; 60: 1440-1451 DOI: 10.1080/0284186X.2021.1957499.
• 19 Castaneda SA, Strasser J. Updates in the Treatment of Breast Cancer with Radiotherapy. Surg Oncol Clin N Am 2017; 26: 371-382 DOI: 10.1016/J.SOC.2017.01.013.
• 20 Pusic AL, Klassen AF, Scott AM. et al. Development of a new patient-reported outcome measure for breast surgery: The BREAST-Q. Plast Reconstr Surg 2009; 124: 345-353 DOI: 10.1097/PRS.0b013e3181aee807.
• 21 Ricci JA, Epstein S, Momoh AO. et al. A meta-analysis of implant-based breast reconstruction and timing of adjuvant radiation therapy. J Surg Res 2017; 218: 108-116 DOI: 10.1016/j.jss.2017.05.072.
• 22 Olinger TA, Berlin NL, Qi J. et al. Outcomes of Immediate Implant-Based Mastectomy Reconstruction in Women with Previous Breast Radiotherapy. Plast Reconstr Surg 2020; 145: 1029e-1039e DOI: 10.1097/PRS.0000000000006811.
• 23 Momoh AO, Ahmed R, Kelley BP. et al. A systematic review of complications of implant-based breast reconstruction with prereconstruction and postreconstruction radiotherapy. Ann Surg Oncol 2014; 21: 118-124 DOI: 10.1245/s10434-013-3284-z.
• 24 Rojas DP, Leonardi MC, Frassoni S. et al. Implant risk failure in patients undergoing postmastectomy 3-week hypofractionated radiotherapy after immediate reconstruction. Radiother Oncol 2021; 163: 105-113 DOI: 10.1016/J.RADONC.2021.08.006.
• 25 Schaverien MV., Macmillan RD, McCulley SJ. Is immediate autologous breast reconstruction with postoperative radiotherapy good practice?: a systematic review of the literature. J Plast Reconstr Aesthet Surg 2013; 66: 1637-1651 DOI: 10.1016/J.BJPS.2013.06.059.
• 26 Jugenburg M, Disa JJ, Pusic AL. et al. Impact of radiotherapy on breast reconstruction. Clin Plast Surg 2007; 34: 29-37 DOI: 10.1016/J.CPS.2006.11.013.
• 27 El-Sabawi B, Sosin M, Carey JN. et al. Breast reconstruction and adjuvant therapy: A systematic review of surgical outcomes. J Surg Oncol 2015; 112: 458-464 DOI: 10.1002/JSO.24028.
• 28 Wilkins EG, Hamill JB, Kim HM. et al. Complications in Postmastectomy Breast Reconstruction: One-year Outcomes of the Mastectomy Reconstruction Outcomes Consortium (MROC) Study. Ann Surg 2018; 267: 164-170 DOI: 10.1097/SLA.0000000000002033.
• 29 He S, Yin J, Robb GL. et al. Considering the Optimal Timing of Breast Reconstruction With Abdominal Flaps With Adjuvant Irradiation in 370 Consecutive Pedicled Transverse Rectus Abdominis Myocutaneous Flap and Free Deep Inferior Epigastric Perforator Flap Performed in a Chinese Oncology Center: Is There a Significant Difference Between Immediate and Delayed?. Ann Plast Surg 2017; 78: 633-640 DOI: 10.1097/SAP.0000000000000927.
• 30 Tran NV., Chang DW, Gupta A. et al. Comparison of immediate and delayed free TRAM flap breast reconstruction in patients receiving postmastectomy radiation therapy. Plast Reconstr Surg 2001; 108: 78-82 DOI: 10.1097/00006534-200107000-00013.
• 31 Carlson GW, Page AL, Peters K. et al. Effects of radiation therapy on pedicled transverse rectus abdominis myocutaneous flap breast reconstruction. Ann Plast Surg 2008; 60: 568-572 DOI: 10.1097/SAP.0B013E31815B6CED.
• 32 Momoh AO, Colakoglu S, De Blacam C. et al. Delayed autologous breast reconstruction after postmastectomy radiation therapy: is there an optimal time?. Ann Plast Surg 2012; 69: 14-18 DOI: 10.1097/SAP.0B013E31821EE4B6.
• 33 Mull AB, Qureshi AA, Zubovic E. et al. Impact of Time Interval between Radiation and Free Autologous Breast Reconstruction. J Reconstr Microsurg 2017; 33: 130-136 DOI: 10.1055/S-0036-1593806.
• 34 Baumann DP, Crosby MA, Selber JC. et al. Optimal timing of delayed free lower abdominal flap breast reconstruction after postmastectomy radiation therapy. Plast Reconstr Surg 2011; 127: 1100-1106 DOI: 10.1097/PRS.0B013E3182043652.
• 35 Berbers J, Van Baardwijk A, Houben R. et al. Reconstruction: before or after postmastectomy radiotherapy?“ A systematic review of the literature. Eur J Cancer 2014; 50: 2752-2762 DOI: 10.1016/J.EJCA.2014.07.023.
• 36 Nahabedian MY, Cocilovo C. Two-Stage Prosthetic Breast Reconstruction: A Comparison Between Prepectoral and Partial Subpectoral Techniques. Plast Reconstr Surg 2017; 140: 22S-30S DOI: 10.1097/PRS.0000000000004047.
• 37 Sinnott CJ, Persing SM, Pronovost M. et al. Impact of Postmastectomy Radiation Therapy in Prepectoral Versus Subpectoral Implant-Based Breast Reconstruction. Ann Surg Oncol 2018; 25: 2899-2908 DOI: 10.1245/S10434-018-6602-7.
• 38 Ascherman JA, Hanasono MM, Newman MI. et al. Implant reconstruction in breast cancer patients treated with radiation therapy. Plast Reconstr Surg 2006; 117: 359-365 DOI: 10.1097/01.PRS.0000201478.64877.87.
• 39 Yun JH, Diaz R, Orman AG. Breast Reconstruction and Radiation Therapy. Cancer Control 2018; 25 DOI: 10.1177/1073274818795489.
• 40 Ho AY, Hu ZI, Mehrara BJ. et al. Radiotherapy in the setting of breast reconstruction: types, techniques, and timing. Lancet Oncol 2017; 18: e742-e753 DOI: 10.1016/S1470-2045(17)30617-4.
• 41 Krishnan NM, Fischer JP, Basta MN. et al. Is Single-Stage Prosthetic Reconstruction Cost Effective? A Cost-Utility Analysis for the Use of Direct-to-Implant Breast Reconstruction Relative to Expander-Implant Reconstruction in Postmastectomy Patients. Plast Reconstr Surg 2016; 138: 537-547 DOI: 10.1097/PRS.0000000000002428.
• 42 Cordeiro PG, Albornoz CR, McCormick B. et al. What Is the Optimum Timing of Postmastectomy Radiotherapy in Two-Stage Prosthetic Reconstruction: Radiation to the Tissue Expander or Permanent Implant?. Plast Reconstr Surg 2015; 135: 1509-1517 DOI: 10.1097/PRS.0000000000001278.
• 43 Hughes K, Brown C, Perez V. et al. The effect of radiotherapy on implant-based breast reconstruction in the setting of skin-sparing mastectomy: Clinical series and review of complications. Anticancer Res 2012; 32: 553-557 Im Internet: https://pubmed.ncbi.nlm.nih.gov/22287744/ Stand: 07.11.2021
• 44 Roostaeian J, Pavone L, Da Lio A. et al. Immediate placement of implants in breast reconstruction: patient selection and outcomes. Plast Reconstr Surg 2011; 127: 1407-1416 DOI: 10.1097/PRS.0B013E318208D0EA.
• 45 Nava MB, Pennati AE, Lozza L. et al. Outcome of different timings of radiotherapy in implant-based breast reconstructions. Plast Reconstr Surg 2011; 128: 353-359 DOI: 10.1097/PRS.0B013E31821E6C10.
• 46 Vandeweyer E, Deraemaecker R. Radiation therapy after immediate breast reconstruction with implants. Plast Reconstr Surg 2000; 106: 56-58 DOI: 10.1097/00006534-200007000-00009.
• 47 Naoum GE, Salama L, Niemierko A. et al. Single Stage Direct-to-Implant Breast Reconstruction Has Lower Complication Rates Than Tissue Expander and Implant and Comparable Rates to Autologous Reconstruction in Patients Receiving Postmastectomy Radiation. Int J Radiat Oncol Biol Phys 2020; 106: 514-524 DOI: 10.1016/j.ijrobp.2019.11.008.
• 48 Coudé Adam H, Frisell A, Liu Y. et al. Effect of radiotherapy on expanders and permanent implants in immediate breast reconstruction: long-term surgical and patient-reported outcomes in a large multicentre cohort. Br J Surg 2021; 108: 1474-1482 DOI: 10.1093/BJS/ZNAB333.
• 49 Adkinson JM, Miller NF, Eid SM. et al. Tissue Expander Complications Predict Permanent Implant Complications and Failure of Breast Reconstruction. Ann Plast Surg 2015; 75: 24-28 DOI: 10.1097/SAP.0000000000000142.
• 50 Ho A, Cordeiro P, Disa J. et al. Long-term outcomes in breast cancer patients undergoing immediate 2-stage expander/implant reconstruction and postmastectomy radiation. Cancer 2012; 118: 2552-2559 DOI: 10.1002/CNCR.26521.
• 51 Cordeiro PG, Jazayeri L. Two-Stage Implant-Based Breast Reconstruction: An Evolution of the Conceptual and Technical Approach over a Two-Decade Period. Plast Reconstr Surg 2016; 138: 1-11 DOI: 10.1097/PRS.0000000000002243.
• 52 Lee KT, Mun GH. Optimal Sequencing of Postmastectomy Radiotherapy and Two Stages of Prosthetic Reconstruction: A Meta-analysis. Ann Surg Oncol 2017; 24: 1262-1268 DOI: 10.1245/S10434-017-5819-1.
• 53 Anderson PR, Freedman G, Nicolaou N. et al. Postmastectomy chest wall radiation to a temporary tissue expander or permanent breast implant--is there a difference in complication rates?. Int J Radiat Oncol Biol Phys 2009; 74: 81-85 DOI: 10.1016/J.IJROBP.2008.06.1940.
• 54 Hvilsom GB, Hölmich LR, Steding-Jessen M. et al. Delayed breast implant reconstruction: is radiation therapy associated with capsular contracture or reoperations?. Ann Plast Surg 2012; 68: 246-252 DOI: 10.1097/SAP.0B013E318214E69C.
• 55 Baschnagel AM, Shah C, Wilkinson J. Ben et al. Failure rate and cosmesis of immediate tissue expander/implant breast reconstruction after postmastectomy irradiation. Clin Breast Cancer 2012; 12: 428-432 DOI: 10.1016/J.CLBC.2012.09.001.
• 56 Peled AW, Foster RD, Esserman LJ. et al. Increasing the time to expander-implant exchange after postmastectomy radiation therapy reduces expander-implant failure. Plast Reconstr Surg 2012; 130: 503-509 DOI: 10.1097/PRS.0B013E31825DBF15.
• 57 Santosa KB, Chen X, Qi J. et al. Postmastectomy Radiation Therapy and Two-Stage Implant-Based Breast Reconstruction: Is There a Better Time to Irradiate?. Plast Reconstr Surg 2016; 138: 761-769 DOI: 10.1097/PRS.0000000000002534.
• 58 Fujii T, Yajima R, Kuwano H. Implications of Long-term Indwelling of Tissue Expander in Breast Reconstruction: Risk of Expander Rupturing. Anticancer Res 2016; 36: 4337-4340 Im Internet: https://pubmed.ncbi.nlm.nih.gov/27466553/ Stand: 07.11.2021
• 59 Quinn TT, Miller GS, Rostek M. et al. Prosthetic breast reconstruction: indications and update. Gland Surg 2016; 5: 174-186 DOI: 10.3978/J.ISSN.2227-684X.2015.07.01.
• 60 Lentz R, Ng R, Higgins SA. et al. Radiation therapy and expander-implant breast reconstruction: an analysis of timing and comparison of complications. Ann Plast Surg 2013; 71: 269-273 DOI: 10.1097/SAP.0B013E3182834B63.
• 61 Kronowitz SJ, Lam C, Terefe W. et al. A multidisciplinary protocol for planned skin-preserving delayed breast reconstruction for patients with locally advanced breast cancer requiring postmastectomy radiation therapy: 3-year follow-up. Plast Reconstr Surg 2011; 127: 2154-2166 DOI: 10.1097/PRS.0B013E3182131B8E.
• 62 Sbitany H, Gomez-Sanchez C, Piper M. et al. Prepectoral Breast Reconstruction in the Setting of Postmastectomy Radiation Therapy: An Assessment of Clinical Outcomes and Benefits. Plast Reconstr Surg 2019; 143: 10-20 DOI: 10.1097/PRS.0000000000005140.
• 63 Graziano FD, Shay PL, Sanati-Mehrizy P. et al. Prepectoral implant reconstruction in the setting of post-mastectomy radiation. Gland Surg 2021; 10: 411-416 DOI: 10.21037/GS.2020.03.33.
• 64 Elswick SM, Harless CA, Bishop SN. et al. Prepectoral Implant-Based Breast Reconstruction with Postmastectomy Radiation Therapy. Plast Reconstr Surg 2018; 142: 1-12 DOI: 10.1097/PRS.0000000000004453.
• 65 Atkins KM, Truong LT, Rawal B. et al. Effects of Postmastectomy Radiation Therapy on Immediate Tissue Expander and Acellular Dermal Matrix Reconstruction: Results of a Prospective Clinical Trial. Pract Radiat Oncol 2019; 9: 338-346 DOI: 10.1016/J.PRRO.2019.04.009.
• 66 Mitchell RE. Porcine acellular dermis-assisted breast reconstruction: influence of adjuvant radiotherapy on complications and outcomes. Plast Reconstr surgery Glob open 2013; 1 DOI: 10.1097/GOX.0000000000000020.
• 67 Chung AM, Stein MJ, Ghumman A. et al. The effect of post mastectomy radiation therapy on breast reconstruction with and without acellular dermal matrix: a systematic review and meta-analysis protocol. Syst Rev 2019; 8 DOI: 10.1186/S13643-019-0958-Z.
• 68 Sewart E, Turner NL, Conroy EJ. et al. The Impact of Radiotherapy on Patient-reported Outcomes of Immediate Implant-based Breast Reconstruction With and Without Mesh. Ann Surg 2020; Publish Ah: 1-10 DOI: 10.1097/sla.0000000000004245.
• 69 Craig ES, Clemens MW, Koshy JC. et al. Outcomes of Acellular Dermal Matrix for Immediate Tissue Expander Reconstruction with Radiotherapy: A Retrospective Cohort Study. Aesthetic Surg J 2019; 39: 279-288 DOI: 10.1093/ASJ/SJY127.
• 70 Razzouk K, Fitoussi A, Al Khori N. et al. Breast Reconstruction Combining Lipofilling and Prepectoral Prosthesis after Radiotherapy. Plast Reconstr surgery Glob open 2020; 8: e2659 DOI: 10.1097/GOX.0000000000002659.
• 71 Gentilucci M, Mazzocchi M, Alfano C. Effects of Prophylactic Lipofilling After Radiotherapy Compared to Non-Fat Injected Breasts: A Randomized, Objective Study. Aesthetic Surg J 2020; 40: NP597-NP607 DOI: 10.1093/ASJ/SJAA182.
• 72 Ribuffo D, Atzeni M, Guerra M. et al. Treatment of irradiated expanders: Protective lipofilling allows immediate prosthetic breast reconstruction in the setting of postoperative radiotherapy. Aesthetic Plast Surg 2013; 37: 1146-1152 DOI: 10.1007/s00266-013-0221-2.
• 73 Vaia N, Lo Torto F, Marcasciano M. et al. From the “Fat Capsule” to the “Fat Belt”: Limiting Protective Lipofilling on Irradiated Expanders for Breast Reconstruction to Selective Key Areas. Aesthetic Plast Surg 2018; 42: 986-994 DOI: 10.1007/S00266-018-1120-3/FIGURES/9.
• 74 Berry T, Brooks S, Sydow N. et al. Complication rates of radiation on tissue expander and autologous tissue breast reconstruction. Ann Surg Oncol 2010; 17: 3 DOI: 10.1245/S10434-010-1261-3.
• 75 Kelley BP, Ahmed R, Kidwell KM. et al. A systematic review of morbidity associated with autologous breast reconstruction before and after exposure to radiotherapy: Are current practices ideal?. Ann Surg Oncol 2014; 21: 1732-1738 DOI: 10.1245/s10434-014-3494-z.
• 76 Chang EI, Liu TS, Festekjian JH. et al. Effects of radiation therapy for breast cancer based on type of free flap reconstruction. Plast Reconstr Surg 2013; 131 DOI: 10.1097/PRS.0B013E3182729D33.
• 77 Tran NV., Evans GRD, Kroll SS. et al. Postoperative adjuvant irradiation: effects on tranverse rectus abdominis muscle flap breast reconstruction. Plast Reconstr Surg 2000; 106: 313-317 DOI: 10.1097/00006534-200008000-00011.
• 78 Garvey PB, Clemens MW, Hoy AE. et al. Muscle-sparing TRAM flap does not protect breast reconstruction from postmastectomy radiation damage compared with the DIEP flap. Plast Reconstr Surg 2014; 133: 223-233 DOI: 10.1097/01.PRS.0000436845.92623.9A.
• 79 Crisera CA, Chang EI, Da Lio AL. et al. Immediate free flap reconstruction for advanced-stage breast cancer: is it safe?. Plast Reconstr Surg 2011; 128: 32-41 DOI: 10.1097/PRS.0B013E3182174119.
• 80 Barry M, Kell MR. Radiotherapy and breast reconstruction: a meta-analysis. Breast Cancer Res Treat 2011; 127: 15-22 DOI: 10.1007/S10549-011-1401-X.
• 81 Spear SL, Ducic I, Low M. et al. The effect of radiation on pedicled TRAM flap breast reconstruction: outcomes and implications. Plast Reconstr Surg 2005; 115: 84-95 DOI: 10.1097/01.PRS.0000145723.05286.F7.
• 82 Munder B, Andree C, Witzel C. et al. The DIEP Flap as Well-established Method of Choice for Autologous Breast Reconstruction with a Low Complication Rate – Retrospective Single-centre 10-Year Experience. Geburtshilfe Frauenheilkd 2020; DOI: 10.1055/A-1116-2102.
• 83 Craig ES, Lentz R, Srinivasa D. et al. Three-dimensional Analysis of How Radiation Affects Deep Inferior Epigastric Perforator (DIEP) Flap Volume, Projection, and Position in Breast Cancer Reconstruction. Ann Plast Surg 2018; 81: 235-239 DOI: 10.1097/SAP.0000000000001462.
• 84 Patel NG, Ramakrishnan V. Microsurgical Tissue Transfer in Breast Reconstruction. Clin Plast Surg 2017; 44: 345-359 DOI: 10.1016/J.CPS.2016.12.002.
• 85 Clarke-Pearson EM, Chadha M, Dayan E. et al. Comparison of irradiated versus nonirradiated DIEP flaps in patients undergoing immediate bilateral DIEP reconstruction with unilateral postmastectomy radiation therapy (PMRT). Ann Plast Surg 2013; 71: 250-254 DOI: 10.1097/SAP.0B013E31828986EC.
• 86 Razzano S, Marongiu F, Wade R. et al. Optimizing DIEP Flap Insetting for Immediate Unilateral Breast Reconstruction: A Prospective Cohort Study of Patient-Reported Aesthetic Outcomes. Plast Reconstr Surg 2019; 143: 261e-270e DOI: 10.1097/PRS.0000000000005277.
• 87 Odobescu A, Keith JN. Preshaping DIEP Flaps: Simplifying and Optimizing Breast Reconstruction Aesthetics. Plast Reconstr Surg 2021; 147: 1059-1061 DOI: 10.1097/PRS.0000000000007889.
• 88 Clough KB, O’Donoghue JM, Fitoussi AD. et al. Prospective evaluation of late cosmetic results following breast reconstruction: I. Implant reconstruction. Plast Reconstr Surg 2001; 107: 1702-1709 DOI: 10.1097/00006534-200106000-00010.
• 89 Pirro O, Mestak O, Vindigni V. et al. Comparison of Patient-reported Outcomes after Implant Versus Autologous Tissue Breast Reconstruction Using the BREAST-Q. Plast Reconstr surgery Glob open. 2017; 5 DOI: 10.1097/GOX.0000000000001217.
• 90 Sgarzani R, Negosanti L, Morselli PG. et al. Patient Satisfaction and Quality of Life in DIEAP Flap versus Implant Breast Reconstruction. Surg Res Pract 2015; 2015: 1-7 DOI: 10.1155/2015/405163.
• 91 Toyserkani NM, Jørgensen MG, Tabatabaeifar S. et al. Autologous versus implant-based breast reconstruction: A systematic review and meta-analysis of Breast-Q patient-reported outcomes. J Plast Reconstr Aesthet Surg 2020; 73: 278-285 DOI: 10.1016/J.BJPS.2019.09.040.
• 92 Rogers NE, Allen RJ. Radiation effects on breast reconstruction with the deep inferior epigastric perforator flap. Plast Reconstr Surg 2002; 109: 1919-1924 DOI: 10.1097/00006534-200205000-00022.
• 93 Garvey PB, Clemens MW, Hoy AE. et al. Muscle-sparing TRAM flap does not protect breast reconstruction from postmastectomy radiation damage compared with the DIEP flap. Plast Reconstr Surg 2014; 133: 223-233 DOI: 10.1097/01.PRS.0000436845.92623.9A.
• 94 Rochlin DH, Jeong AR, Goldberg L. et al. Postmastectomy radiation therapy and immediate autologous breast reconstruction: integrating perspectives from surgical oncology, radiation oncology, and plastic and reconstructive surgery. J Surg Oncol 2015; 111: 251-257 DOI: 10.1002/JSO.23804.
• 95 Li L, Chen Y, Chen J. et al. Adjuvant chemotherapy increases the prevalence of fat necrosis in immediate free abdominal flap breast reconstruction. J Plast Reconstr Aesthet Surg 2014; 67: 461-467 DOI: 10.1016/J.BJPS.2014.01.008.
• 96 Khansa I, Momoh AO, Patel PP. et al. Fat necrosis in autologous abdomen-based breast reconstruction: A systematic review. Plast Reconstr Surg 2013; 131: 443-452 DOI: 10.1097/PRS.0B013E31827C6DC2.
• 97 Billig J, Jagsi R, Qi J. et al. Should Immediate Autologous Breast Reconstruction Be Considered in Women Who Require Postmastectomy Radiation Therapy? A Prospective Analysis of Outcomes. Plast Reconstr Surg 2017; 139: 1279-1288
• 98 Taghizadeh R, Moustaki M, Harris S. et al. Does post-mastectomy radiotherapy affect the outcome and prevalence of complications in immediate DIEP breast reconstruction? A prospective cohort study. J Plast Reconstr Aesthet Surg 2015; 68: 1379-1385 DOI: 10.1016/J.BJPS.2015.06.003.
• 99 Liew B, Southall C, Kanapathy M. et al. Does post-mastectomy radiation therapy worsen outcomes in immediate autologous breast flap reconstruction? A systematic review and meta-analysis. J Plast Reconstr Aesthetic Surg 2021; 74: 3260-3280 DOI: 10.1016/J.BJPS.2021.08.005.
• 100 Gill PS, Hunt JP, Guerra AB. et al. A 10-year retrospective review of 758 DIEP flaps for breast reconstruction. Plast Reconstr Surg 2004; 113: 1153-1160 DOI: 10.1097/01.PRS.0000110328.47206.50.
• 101 Leonardi MC, Garusi C, Santoro L. et al. Impact of medical discipline and observer gender on cosmetic outcome evaluation in breast reconstruction using transverse rectus abdominis myocutaneous (TRAM) flap and radiotherapy. J Plast Reconstr Aesthet Surg 2010; 63: 2091-2097 DOI: 10.1016/J.BJPS.2010.02.013.
• 102 McKeown DJ, Hogg FJ, Brown IM. et al. The timing of autologous latissimus dorsi breast reconstruction and effect of radiotherapy on outcome. J Plast Reconstr Aesthet Surg 2009; 62: 488-493 DOI: 10.1016/J.BJPS.2007.11.046.
• 103 O’Connell RL, Di Micco R, Khabra K. et al. Comparison of immediate versus delayed DIEP flap reconstruction in women who require postmastectomy radiotherapy. Plast Reconstr Surg 2018; 142: 594-605 DOI: 10.1097/PRS.0000000000004676.
• 104 Rozen WM, Bhullar HK, Hunter-Smith D. How to assess a CTA of the abdomen to plan an autologous breast reconstruction. Gland Surg 2019; 8: S291-S296 DOI: 10.21037/gs.2019.04.10.
• 105 Malagón-López P, Carrasco-López C, García-Senosiain O. et al. When to assess the DIEP flap perfusion by intraoperative indocyanine green angiography in breast reconstruction?. Breast 2019; 47: 102-108 DOI: 10.1016/j.breast.2019.07.009.
• 106 Anker AM, Prantl L, Strauss C. et al. Assessment of DIEP Flap Perfusion with Intraoperative Indocyanine Green Fluorescence Imaging in Vasopressor-Dominated Hemodynamic Support Versus Liberal Fluid Administration: A Randomized Controlled Trial With Breast Cancer Patients. Ann Surg Oncol 2020; 27: 399-406 DOI: 10.1245/s10434-019-07758-1.
• 107 Thiessen FEF, Tondu T, Cloostermans B. et al. Dynamic InfraRed Thermography (DIRT) in DIEP-flap breast reconstruction: A review of the literature. Eur J Obstet Gynecol Reprod Biol 2019; 242: 47-55 DOI: 10.1016/j.ejogrb.2019.08.008.
• 108 Schaverien MV., Macmillan RD, McCulley SJ. Is immediate autologous breast reconstruction with postoperative radiotherapy good practice?: a systematic review of the literature. J Plast Reconstr Aesthet Surg 2013; 66: 1637-1651 DOI: 10.1016/J.BJPS.2013.06.059.
• 109 El-Sabawi B, Ho AL, Sosin M. et al. Patient-centered outcomes of breast reconstruction in the setting of post-mastectomy radiotherapy: A comprehensive review of the literature. J Plast Reconstr Aesthet Surg 2017; 70: 768-780 DOI: 10.1016/J.BJPS.2017.02.015.
• 110 Prantl L, Moellhoff N, Von Fritschen U. et al. Effect of Radiation Therapy on Microsurgical Deep Inferior Epigastric Perforator Flap Breast Reconstructions: A Matched Cohort Analysis of 4577 Cases. Ann Plast Surg 2021; 86: 627-631 DOI: 10.1097/SAP.0000000000002628.
• 111 Disa JJ, Matros E. Discussion: Reconstruction of the Irradiated Breast: A National Claims-Based Assessment of Postoperative Morbidity. Plast Reconstr Surg 2017; 139: 793-794 DOI: 10.1097/PRS.0000000000003169.
• 112 Kronowitz SJ, Hunt KK, Kuerer HM. et al. Delayed-immediate breast reconstruction. Plast Reconstr Surg 2004; 113: 1617-1628 DOI: 10.1097/01.PRS.0000117192.54945.88.
• 113 National Mastectomy and Breast Reconstruction Audit - Fourth Report – Royal College of Surgeons. Im Internet: https://www.rcseng.ac.uk/library-and-publications/rcs-publications/docs/mastectomy-breast-4/; Stand: 29.01.2022
• 114 Reinders FCJ, Young-Afat DA, Batenburg MCT. et al. Higher reconstruction failure and less patient-reported satisfaction after post mastectomy radiotherapy with immediate implant-based breast reconstruction compared to immediate autologous breast reconstruction. Breast Cancer 2020; 27: 435-444 DOI: 10.1007/S12282-019-01036-4.
• 115 Nestle-Krämling C, Bölke E, Budach W. et al. Breast reconstruction after neoadjuvant radio chemotherapy: Review and personal technique IDEAL concept REV-EJMR-D-15-00268. Eur J Med Res 2016; 21 DOI: 10.1186/s40001-016-0219-8.
• 116 Otte M, Nestle-Krämling C, Fertsch S. et al. Conservative mastectomies and Immediate-DElayed AutoLogous (IDEAL) breast reconstruction: the DIEP flap. Gland Surg 2016; 5: 24-31 DOI: 10.3978/j.issn.2227-684X.2015.05.15.
• 117 Fertsch S, Munder B, Hagouan M. et al. Immediate-DElayed AutoLogous (IDEAL) Breast Reconstruction with the DIEP Flap. Chirurgia (Bucur) 2017; 112: 387-393 DOI: 10.21614/chirurgia.112.4.387.
• 118 Sobti N, Weitzman RE, Nealon KP. et al. Evaluation of capsular contracture following immediate prepectoral versus subpectoral direct-to-implant breast reconstruction. Sci Rep 2020; 10 DOI: 10.1038/S41598-020-58094-4.