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Outcomes of whole breast radiation therapy in Asian breast cancer patients with prior cosmetic implants

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Abstract

Background

As breast augmentation has become more popular, an increasing number of women with augmented breasts require treatment for breast cancer. This study aimed to assess the outcomes of postoperative whole breast radiation therapy (WB-RT) in Asian patients with breast cancer who underwent prior cosmetic breast implantation.

Methods

We retrospectively reviewed the medical records of 61 patients with breast cancer who had prior cosmetic breast implants (prior-CBI) and underwent breast-conserving surgery (BCS) and WB-RT between 2015 and 2020. The median implant volume was 238.8 cc, with a median interval of 84.7 months between the prior-CBI and BCS. WB-RT was administered with either conventional fractionation (CF-RT) at 50 Gy in 25 fractions (N = 36) or hypofractionation (HF-RT) at 42.6 Gy in 16 fractions (N = 25). The incidences of implant-related complications (IRC) and their contributing factors were analyzed.

Results

After a median follow-up of 43.5 months, the 3-year cumulative incidences of IRC and implant loss were 17.2% and 4.9%, respectively. Among the four (6.6%) patients who opted for implant removal after RT, three were potentially related to RT-related capsular contracture. There was no difference in the 3-year cumulative IRC rates following CF-RT and HF-RT (12.2% and 26.7%, respectively; p = 0.120). The risk factors for IRC included a larger implant size (> 260 cc) and a higher ratio of breast tissue to implant volume.

Conclusions

This study demonstrated a favorable safety profile of WB-RT for treatment of breast cancer in Asian women with prior-CBI. The integration of HF-RT following BCS was thought to be a feasible approach.

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Data availability

The data that support the findings of this study are available from the authors upon reasonable request and with permission from the institutional review board of Samsung Medical Center.

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Funding

This work was supported by grants from the National Research Foundation of Korea funded by the Ministry of Education (RS-2023-00252283) and Samsung Medical Center (SMO1230151).

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Authors and Affiliations

  1. Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Republic of Korea

    Nalee Kim, Won Kyung Cho, Won Park & Haeyoung Kim

  2. Division of Breast Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Jeong Eon Lee, Seok Jin Nam, Seok Won Kim, Jonghan Yu, Byung Joo Chae, Sei Kyung Lee & Jai-Min Ryu

  3. Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Eun Sook Ko

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  1. Nalee Kim
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Contributions

NK: conceptualization, methodology, formal analysis, data curation, writing—original draft, writing—review and editing, visualization; WKC: investigation, resources, writing—review and editing; Won Park: investigation, resources, writing—review and editing; JEL: investigation, resources, writing—review and editing; SJN: investigation, resources, writing—review and editing; SWK: investigation, resources, writing—review and editing; JY: investigation, resources, writing—review and editing; BJC: investigation, resources, writing-review and editing; SKL: investigation, resources, writing—review and editing; J-MR: investigation, resources, writing—review and editing; ESK: investigation, resources, writing—review and editing, data curation; HK: conceptualization, writing—original draft, writing—review and editing, supervision, project administration, funding acquisition.

Corresponding author

Correspondence to Haeyoung Kim.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study, formal consent is not required.

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Kim, N., Cho, W.K., Park, W. et al. Outcomes of whole breast radiation therapy in Asian breast cancer patients with prior cosmetic implants. Breast Cancer 31, 391–400 (2024). https://doi.org/10.1007/s12282-024-01547-9

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