Outcomes of Combined Treatment for Breast Cancer with Immediate Implant-Based Breast Reconstruction, Chemotherapy and Conformal Radiotherapy

Purpose: To evaluate the oncological results and late complication rate in breast cancer patients who underwent immediate implant-based breast reconstruction and adjuvant radiotherapy. Material and methods: 32 patients with I–IIIC breast cancer after combined treatment which included immediate implant-based breast reconstruction, chemotherapy and radiotherapy, were reviewed. Results: All 32 patients got skin erythema as an acute adverse effect. 6 (18 %) of them got acute mucositis. Median follow-up was 35 months (range 12–112 months). 2 (6 %) patients had local recurrence after 46 and 31 months since the operation day. Locoregional control rate was 94 %. 9 (28 %) patients presented distant metastases at term 8–71 months since the operation day, and metastases in bones, brain, lungs, liver and non-regional lymph nodes were diagnosed. 2 (6 %) patients died because of disease progression. Late adverse effects of skin and soft tissue in irradiated area were found in 4 (13 %) patients – capsular contracture was diagnosed 1 (n = 1), 2 (n = 2) and 3 (n = 1) stages. In two cases of four, capsular contracture was asymptomatic and found during the second stage of breast reconstruction while changing tissue expander to implant. Capsulotomy was performed, and aesthetic effect was good. In one case capsular contracture was the reason of implant removal, and then second reconstruction using tissue expander was performed. Conclusion: Nowadays immediate implant-based breast reconstruction is an essential part of combined treatment. Breast cancer patients after immediate implant-based breast reconstruction can be treated in adequate manner, and breast reconstruction is not a contraindication for radiotherapy. Low complication rates can still be acquired with the use of state-of-art 3D and 4D radiotherapy techniques and supportive care.