ESTRO Multidisciplinary Management of Breast Cancer 2017

Timing of RT and reconstruction FLAP

Complication

RT before Flap reconstruction Pooled rate (95% CI)

RT after Flap reconstruction Pooled rate (95% CI)

Wound healing

10% (0.04-0.77)

14% (0-0.38)

Fat necrosis

10% (0.06-0.14)

13% (0.07-0.2)

Infection

4% (0.02-0.06)

6% (0.03-0.1)

Hematoma

2% (0.01-0.04)

1% (0.01-0.04)

Seroma

4% (0.02-0.05)

4% (0-0.12)

Flap fibrosis

-

27% (0.12-0.45)

Flap loss

1% (0-0.02)

4% (0-0.04)

Partial flap necrosis

6% (0.03-0.11)

-

4%(0.03-0.06)

-

Vascular thrombosis (reoperation)

Similar rates of complications and success for pre- and post-reconstruction RT

Immediate autologous reconstruction should be considered as a valuable option even when PMRT is indicated (up to 4% flap loss)

Kelley, Ann Surg Onc 2014