Immediate Breast Reconstruction with Abdominal Free Flap and Adjuvant Radiotherapy, Evaluation of Quality of Life and Outcomes.

Background: The effects of postoperative radiotherapy on free flap based breast reconstruction are still controversial. Poor outcomes, breast distortion and fat necrosis have been traditionally documented. The aim of this study was to evaluate whether adjuvant radiotherapy affects the quality of life, satisfaction and cosmetic result in patients undergoing immediate breast reconstruction with autologous free flap. Methods: Between January 2013 and December 2016, 230 patients underwent mastectomy with immediate free flap reconstruction at the authors institution. Patients were divided in two groups depending on having received PMRT (Post mastectomy radiotherapy). Quality of life measured with BREAST Q questionnaire, self-reported aesthetic outcomes and general satisfaction were assessed and compared. Fat necrosis of the flap and its severity was also analysed as the main surgical outcome. Results: Mean follow-up time after reconstruction was 23 months (6-48 months) No significant difference in quality of life or satisfaction scores were found between patients that underwent PMRT and patients who did not receive adjuvant RT. There were no significant differences in rates of fat necrosis among both groups. (11.1% vs 13.76% p=0.75) Conclusions: PMRT in patients undergoing immediate breast reconstruction with free flap does not seem to affect quality of life, satisfaction with the outcome and the cosmetic result as perceived by the patients. The potential need for postoperative radiotherapy should not hinder women from the benefits of autologous immediate breast reconstruction. (C)2017American Society of Plastic Surgeons

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