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Reduction mammoplasty and mastopexy in the previously irradiated breast–a systematic review and meta-analysis

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@article{209e76760009403c9b5e845c972dc42e,
title = "Reduction mammoplasty and mastopexy in the previously irradiated breast–a systematic review and meta-analysis",
abstract = "Breast cancer is the most common cancer diagnosed in women, and early stages are treated with lumpectomy and irradiation. Irradiation, however, leads to reduced vascularization and fibrosis, which may influence the cosmetic outcome unfavourably and increase complications after subsequent surgery on irradiated breasts. Patients with significant asymmetry after treatment may desire corrective reduction mammoplasty or mastopexy, but this may be associated with increased complication rates. This systematic review and meta-analysis aimed to investigate postoperative complication rates after bilateral reduction mammoplasty or mastopexy in women who had undergone unilateral lumpectomy and irradiation. PubMed, Medline, EMBASE and Cochrane databases were searched for eligible studies. After screening titles and abstracts, 14 full text studies were reviewed, and 7 of these were included in the analysis. The meta-analysis showed a significantly higher complication rate in the irradiated breast compared to the non-irradiated breast, rate ratio 4.82 (95% CI: 1.58, 14.70), p = 0.006. The complication rate was 54% in the irradiated breast (58/107) compared to 8% (9/107) in the non-irradiated breast (p = 0.034). This study suggests that reduction mammoplasty or mastopexy in the previously irradiated breast is associated with a significantly increased risk of complications. Careful patient selection and information are paramount in the treatment of this patient group.",
keywords = "Humans, Mammaplasty/adverse effects, complication, mastopexy, radiation, Irradiation, breast surgery, reduction mammoplasty",
author = "Lorentzen, {Anne Kathrine} and J{\o}rgen Lock-Andersen and Matthiessen, {Louise Wichmann} and Klausen, {Tobias Wirenfeldt} and H{\"o}lmich, {Lisbet Rosenkrantz}",
note = "Publisher Copyright: {\textcopyright} 2021 Acta Chirurgica Scandinavica Society. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",
year = "2021",
month = dec,
day = "1",
doi = "10.1080/2000656X.2021.1888745",
language = "English",
volume = "55",
pages = "330--338",
journal = "Journal of Plastic Surgery and Hand Surgery",
issn = "2000-656X",
publisher = "Informa Healthcare",
number = "6",

}

RIS

TY - JOUR

T1 - Reduction mammoplasty and mastopexy in the previously irradiated breast–a systematic review and meta-analysis

AU - Lorentzen, Anne Kathrine

AU - Lock-Andersen, Jørgen

AU - Matthiessen, Louise Wichmann

AU - Klausen, Tobias Wirenfeldt

AU - Hölmich, Lisbet Rosenkrantz

N1 - Publisher Copyright: © 2021 Acta Chirurgica Scandinavica Society. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/12/1

Y1 - 2021/12/1

N2 - Breast cancer is the most common cancer diagnosed in women, and early stages are treated with lumpectomy and irradiation. Irradiation, however, leads to reduced vascularization and fibrosis, which may influence the cosmetic outcome unfavourably and increase complications after subsequent surgery on irradiated breasts. Patients with significant asymmetry after treatment may desire corrective reduction mammoplasty or mastopexy, but this may be associated with increased complication rates. This systematic review and meta-analysis aimed to investigate postoperative complication rates after bilateral reduction mammoplasty or mastopexy in women who had undergone unilateral lumpectomy and irradiation. PubMed, Medline, EMBASE and Cochrane databases were searched for eligible studies. After screening titles and abstracts, 14 full text studies were reviewed, and 7 of these were included in the analysis. The meta-analysis showed a significantly higher complication rate in the irradiated breast compared to the non-irradiated breast, rate ratio 4.82 (95% CI: 1.58, 14.70), p = 0.006. The complication rate was 54% in the irradiated breast (58/107) compared to 8% (9/107) in the non-irradiated breast (p = 0.034). This study suggests that reduction mammoplasty or mastopexy in the previously irradiated breast is associated with a significantly increased risk of complications. Careful patient selection and information are paramount in the treatment of this patient group.

AB - Breast cancer is the most common cancer diagnosed in women, and early stages are treated with lumpectomy and irradiation. Irradiation, however, leads to reduced vascularization and fibrosis, which may influence the cosmetic outcome unfavourably and increase complications after subsequent surgery on irradiated breasts. Patients with significant asymmetry after treatment may desire corrective reduction mammoplasty or mastopexy, but this may be associated with increased complication rates. This systematic review and meta-analysis aimed to investigate postoperative complication rates after bilateral reduction mammoplasty or mastopexy in women who had undergone unilateral lumpectomy and irradiation. PubMed, Medline, EMBASE and Cochrane databases were searched for eligible studies. After screening titles and abstracts, 14 full text studies were reviewed, and 7 of these were included in the analysis. The meta-analysis showed a significantly higher complication rate in the irradiated breast compared to the non-irradiated breast, rate ratio 4.82 (95% CI: 1.58, 14.70), p = 0.006. The complication rate was 54% in the irradiated breast (58/107) compared to 8% (9/107) in the non-irradiated breast (p = 0.034). This study suggests that reduction mammoplasty or mastopexy in the previously irradiated breast is associated with a significantly increased risk of complications. Careful patient selection and information are paramount in the treatment of this patient group.

KW - Humans

KW - Mammaplasty/adverse effects

KW - complication

KW - mastopexy

KW - radiation

KW - Irradiation

KW - breast surgery

KW - reduction mammoplasty

UR - http://www.scopus.com/inward/record.url?scp=85101622841&partnerID=8YFLogxK

U2 - 10.1080/2000656X.2021.1888745

DO - 10.1080/2000656X.2021.1888745

M3 - Review

C2 - 33630696

AN - SCOPUS:85101622841

VL - 55

SP - 330

EP - 338

JO - Journal of Plastic Surgery and Hand Surgery

JF - Journal of Plastic Surgery and Hand Surgery

SN - 2000-656X

IS - 6

ER -

ID: 66502420