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dc.contributor.authorO'Connell, RLen_US
dc.contributor.authorDi Micco, Ren_US
dc.contributor.authorKhabra, Ken_US
dc.contributor.authorKirby, AMen_US
dc.contributor.authorHarris, PAen_US
dc.contributor.authorJames, SEen_US
dc.contributor.authorPower, Ken_US
dc.contributor.authorRamsey, KWDen_US
dc.contributor.authorRusby, JEen_US
dc.coverage.spatialUnited Statesen_US
dc.identifier.citationPlast Reconstr Surg, 2018, 142 (3), pp. 594 - 605en_US
dc.description.abstractBACKGROUND: The authors investigated aesthetic outcome and patient satisfaction in women who have undergone deep inferior epigastric artery perforator (DIEP) flap reconstruction in the setting of postmastectomy radiotherapy. Patients who underwent DIEP flap reconstruction without postmastectomy radiotherapy were the control group. METHODS: Participants who had undergone DIEP flap reconstruction between September 1, 2009, and September 1, 2014, were recruited, answered the BREAST-Q, and underwent three-dimensional surface-imaging. A panel assessed the aesthetic outcome by reviewing these images. RESULTS: One hundred sixty-seven women participated. Eighty women (48 percent) underwent immediate DIEP flap reconstruction and no postmastectomy radiotherapy; 28 (17 percent) underwent immediate DIEP flap reconstruction with postmastectomy radiotherapy; 38 (23 percent) underwent simple mastectomy, postmastectomy radiotherapy, and DIEP flap reconstruction; and 21 (13 percent) underwent mastectomy with temporizing implant, postmastectomy radiotherapy, and DIEP flap reconstruction. Median satisfaction scores were significantly different among the groups (p < 0.05). Post hoc comparison demonstrated that women who had an immediate DIEP flap reconstruction were significantly less satisfied if they had postmastectomy radiotherapy. In women requiring radiotherapy, those undergoing delayed reconstruction after a simple mastectomy were most satisfied, but there was no significant difference between the immediate DIEP flap and temporizing implant groups. Median panel scores differed among groups, being significantly higher if the immediate reconstruction was not subjected to radiotherapy. There was no significant difference in panel assessment among the three groups of women who had received radiotherapy. CONCLUSIONS: Patients who avoid having their immediate DIEP flap reconstruction irradiated are more satisfied and have better aesthetic outcome than those who undergo postmastectomy radiotherapy. In women requiring radiotherapy and who wish to have an immediate or "delayed-immediate" reconstruction, there were no significant differences in panel or patient satisfaction. Therefore, immediate DIEP flap reconstruction or mastectomy with temporizing implant then DIEP flap surgery are acceptable treatment pathways in the context of post-mastectomy radiotherapy.en_US
dc.format.extent594 - 605en_US
dc.subjectBreast Neoplasmsen_US
dc.subjectEpigastric Arteriesen_US
dc.subjectMiddle Ageden_US
dc.subjectPatient Reported Outcome Measuresen_US
dc.subjectPatient Satisfactionen_US
dc.subjectPerforator Flapen_US
dc.subjectRadiotherapy, Adjuvanten_US
dc.subjectRetrospective Studiesen_US
dc.subjectTime Factorsen_US
dc.titleComparison of Immediate versus Delayed DIEP Flap Reconstruction in Women Who Require Postmastectomy Radiotherapy.en_US
dc.typeJournal Article
rioxxterms.typeJournal Article/Reviewen_US
dc.relation.isPartOfPlast Reconstr Surgen_US
pubs.notesNot knownen_US
pubs.organisational-group/ICR/Primary Group
pubs.organisational-group/ICR/Primary Group/ICR Divisions
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Breast Cancer Radiotherapy
pubs.organisational-group/ICR/Primary Group/ICR Divisions/Radiotherapy and Imaging/Breast Cancer Radiotherapy/Breast Cancer Radiotherapy (hon.)
pubs.organisational-group/ICR/Primary Group/Royal Marsden Clinical Units
pubs.embargo.termsNot knownen_US
icr.researchteamBreast Cancer Radiotherapyen_US
dc.contributor.icrauthorKirby, Annaen_US

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