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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Complications After Mastectomy and Immediate Breast Reconstruction for Breast Cancer: A Claims-Based Analysis</title><author><name sortKey="Jagsi, Reshma" sort="Jagsi, Reshma" uniqKey="Jagsi R" first="Reshma" last="Jagsi">Reshma Jagsi</name><affiliation><nlm:aff id="A1">Department of Radiation Oncology, University of Michigan, Ann Arbor MI</nlm:aff></affiliation></author><author><name sortKey="Jiang, Jing" sort="Jiang, Jing" uniqKey="Jiang J" first="Jing" last="Jiang">Jing Jiang</name><affiliation><nlm:aff id="A2">Division of Quantitative Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX</nlm:aff></affiliation></author><author><name sortKey="Momoh, Adeyiza O" sort="Momoh, Adeyiza O" uniqKey="Momoh A" first="Adeyiza O." last="Momoh">Adeyiza O. Momoh</name><affiliation><nlm:aff id="A3">Section of Plastic Surgery, University of Michigan Health System, Ann Arbor, MI</nlm:aff></affiliation></author><author><name sortKey="Alderman, Amy" sort="Alderman, Amy" uniqKey="Alderman A" first="Amy" last="Alderman">Amy Alderman</name><affiliation><nlm:aff id="A4">Private practice, Alpharetta, GA</nlm:aff></affiliation></author><author><name sortKey="Giordano, Sharon H" sort="Giordano, Sharon H" uniqKey="Giordano S" first="Sharon H." last="Giordano">Sharon H. Giordano</name><affiliation><nlm:aff id="A5">Departments of Health Services Research and Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX</nlm:aff></affiliation></author><author><name sortKey="Buchholz, Thomas A" sort="Buchholz, Thomas A" uniqKey="Buchholz T" first="Thomas A." last="Buchholz">Thomas A. Buchholz</name><affiliation><nlm:aff id="A6">Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX</nlm:aff></affiliation></author><author><name sortKey="Pierce, Lori J" sort="Pierce, Lori J" uniqKey="Pierce L" first="Lori J." last="Pierce">Lori J. Pierce</name><affiliation><nlm:aff id="A1">Department of Radiation Oncology, University of Michigan, Ann Arbor MI</nlm:aff></affiliation></author><author><name sortKey="Kronowitz, Steven J" sort="Kronowitz, Steven J" uniqKey="Kronowitz S" first="Steven J." last="Kronowitz">Steven J. Kronowitz</name><affiliation><nlm:aff id="A7">Department of Plastic Surgery, Baylor College of Medicine, Houston, TX</nlm:aff></affiliation></author><author><name sortKey="Smith, Benjamin D" sort="Smith, Benjamin D" uniqKey="Smith B" first="Benjamin D." last="Smith">Benjamin D. Smith</name><affiliation><nlm:aff id="A6">Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX</nlm:aff></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25876011</idno><idno type="pmc">4824182</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4824182</idno><idno type="RBID">PMC:4824182</idno><idno type="doi">10.1097/SLA.0000000000001177</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">003347</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">003347</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Complications After Mastectomy and Immediate Breast Reconstruction for Breast Cancer: A Claims-Based Analysis</title><author><name sortKey="Jagsi, Reshma" sort="Jagsi, Reshma" uniqKey="Jagsi R" first="Reshma" last="Jagsi">Reshma Jagsi</name><affiliation><nlm:aff id="A1">Department of Radiation Oncology, University of Michigan, Ann Arbor MI</nlm:aff></affiliation></author><author><name sortKey="Jiang, Jing" sort="Jiang, Jing" uniqKey="Jiang J" first="Jing" last="Jiang">Jing Jiang</name><affiliation><nlm:aff id="A2">Division of Quantitative Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX</nlm:aff></affiliation></author><author><name sortKey="Momoh, Adeyiza O" sort="Momoh, Adeyiza O" uniqKey="Momoh A" first="Adeyiza O." last="Momoh">Adeyiza O. Momoh</name><affiliation><nlm:aff id="A3">Section of Plastic Surgery, University of Michigan Health System, Ann Arbor, MI</nlm:aff></affiliation></author><author><name sortKey="Alderman, Amy" sort="Alderman, Amy" uniqKey="Alderman A" first="Amy" last="Alderman">Amy Alderman</name><affiliation><nlm:aff id="A4">Private practice, Alpharetta, GA</nlm:aff></affiliation></author><author><name sortKey="Giordano, Sharon H" sort="Giordano, Sharon H" uniqKey="Giordano S" first="Sharon H." last="Giordano">Sharon H. Giordano</name><affiliation><nlm:aff id="A5">Departments of Health Services Research and Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX</nlm:aff></affiliation></author><author><name sortKey="Buchholz, Thomas A" sort="Buchholz, Thomas A" uniqKey="Buchholz T" first="Thomas A." last="Buchholz">Thomas A. Buchholz</name><affiliation><nlm:aff id="A6">Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX</nlm:aff></affiliation></author><author><name sortKey="Pierce, Lori J" sort="Pierce, Lori J" uniqKey="Pierce L" first="Lori J." last="Pierce">Lori J. Pierce</name><affiliation><nlm:aff id="A1">Department of Radiation Oncology, University of Michigan, Ann Arbor MI</nlm:aff></affiliation></author><author><name sortKey="Kronowitz, Steven J" sort="Kronowitz, Steven J" uniqKey="Kronowitz S" first="Steven J." last="Kronowitz">Steven J. Kronowitz</name><affiliation><nlm:aff id="A7">Department of Plastic Surgery, Baylor College of Medicine, Houston, TX</nlm:aff></affiliation></author><author><name sortKey="Smith, Benjamin D" sort="Smith, Benjamin D" uniqKey="Smith B" first="Benjamin D." last="Smith">Benjamin D. Smith</name><affiliation><nlm:aff id="A6">Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX</nlm:aff></affiliation></author></analytic><series><title level="j">Annals of surgery</title><idno type="ISSN">0003-4932</idno><idno type="eISSN">1528-1140</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec id="S1"><title>Objective</title><p id="P1">To evaluate complications after post-mastectomy breast reconstruction, particularly in the setting of adjuvant radiotherapy.</p></sec><sec id="S2"><title>Summary-Background Data</title><p id="P2">Most studies of complications after breast reconstruction have been conducted at centers of excellence; relatively little is known about complication rates in radiated patients treated in the broader community. This information is relevant for breast cancer patients' decision-making.</p></sec><sec id="S3"><title>Methods</title><p id="P3">Using the claims-based MarketScan database, we described complications in 14,894 women undergoing mastectomy for breast cancer from 1998-2007 who received immediate autologous reconstruction (n=2637), immediate implant-based reconstruction (n=3007), or no reconstruction within the first two postoperative years (n=9250). We used a generalized estimating equation to evaluate associations between complications and radiotherapy over time.</p></sec><sec id="S4"><title>Results</title><p id="P4">Wound complications were diagnosed within the first two postoperative years in 2.3% of patients without reconstruction, 4.4% with implants, and 9.5% with autologous reconstruction (p<0.001). Infection was diagnosed within the first two postoperative years in 12.7% of patients without reconstruction, 20.5% with implants, and 20.7% with autologous reconstruction (p<0.001). 5219 (35%) women received radiation. Radiation was not associated with infection in any surgical group within the first six months but was associated with an increased risk of infection in months 7-24 in all three groups (each p<0.001). In months 7-24, radiation was associated with higher odds of implant removal in patients with implant reconstruction (OR 1.48, p<0.001) and fat necrosis in those with autologous reconstruction (OR=1.55; P=0.01).</p></sec><sec id="S5"><title>Conclusions</title><p id="P5">Complication risks after immediate breast reconstruction differ by approach. Radiation therapy appears to modestly increase certain risks, including infection and implant removal.</p></sec></div></front></TEI><pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">0372354</journal-id><journal-id journal-id-type="pubmed-jr-id">646</journal-id><journal-id journal-id-type="nlm-ta">Ann Surg</journal-id><journal-id journal-id-type="iso-abbrev">Ann. Surg.</journal-id><journal-title-group><journal-title>Annals of surgery</journal-title></journal-title-group><issn pub-type="ppub">0003-4932</issn><issn pub-type="epub">1528-1140</issn></journal-meta><article-meta><article-id pub-id-type="pmid">25876011</article-id><article-id pub-id-type="pmc">4824182</article-id><article-id pub-id-type="doi">10.1097/SLA.0000000000001177</article-id><article-id pub-id-type="manuscript">NIHMS772160</article-id><article-categories><subj-group subj-group-type="heading"><subject>Article</subject></subj-group></article-categories><title-group><article-title>Complications After Mastectomy and Immediate Breast Reconstruction for Breast Cancer: A Claims-Based Analysis</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Jagsi</surname><given-names>Reshma</given-names></name><degrees>MD, DPhil</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Jiang</surname><given-names>Jing</given-names></name><degrees>MS</degrees><xref ref-type="aff" rid="A2">2</xref></contrib><contrib contrib-type="author"><name><surname>Momoh</surname><given-names>Adeyiza O.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A3">3</xref></contrib><contrib contrib-type="author"><name><surname>Alderman</surname><given-names>Amy</given-names></name><degrees>MD, MPH</degrees><xref ref-type="aff" rid="A4">4</xref></contrib><contrib contrib-type="author"><name><surname>Giordano</surname><given-names>Sharon H.</given-names></name><degrees>MD, MPH</degrees><xref ref-type="aff" rid="A5">5</xref></contrib><contrib contrib-type="author"><name><surname>Buchholz</surname><given-names>Thomas A.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A6">6</xref></contrib><contrib contrib-type="author"><name><surname>Pierce</surname><given-names>Lori J.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A1">1</xref></contrib><contrib contrib-type="author"><name><surname>Kronowitz</surname><given-names>Steven J.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A7">7</xref></contrib><contrib contrib-type="author"><name><surname>Smith</surname><given-names>Benjamin D.</given-names></name><degrees>MD</degrees><xref ref-type="aff" rid="A6">6</xref></contrib></contrib-group><aff id="A1"><label>1</label>Department of Radiation Oncology, University of Michigan, Ann Arbor MI</aff><aff id="A2"><label>2</label>Division of Quantitative Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX</aff><aff id="A3"><label>3</label>Section of Plastic Surgery, University of Michigan Health System, Ann Arbor, MI</aff><aff id="A4"><label>4</label>Private practice, Alpharetta, GA</aff><aff id="A5"><label>5</label>Departments of Health Services Research and Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX</aff><aff id="A6"><label>6</label>Division of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX</aff><aff id="A7"><label>7</label>Department of Plastic Surgery, Baylor College of Medicine, Houston, TX</aff><author-notes><corresp id="FN1">Correspondence and requests for reprints should be addressed to Dr. Jagsi, Department of Radiation Oncology, University of Michigan; NCRC 2800 Plymouth Rd; Bldg 16/420W, Ann Arbor MI 48109-2800; telephone (734) 936-7810; fax (734) 763-7370; <email>rjagsi@med.umich.edu</email></corresp></author-notes><pub-date pub-type="nihms-submitted"><day>27</day><month>3</month><year>2016</year></pub-date><pub-date pub-type="ppub"><month>2</month><year>2016</year></pub-date><pub-date pub-type="pmc-release"><day>01</day><month>2</month><year>2017</year></pub-date><volume>263</volume><issue>2</issue><fpage>219</fpage><lpage>227</lpage><pmc-comment>elocation-id from pubmed: 10.1097/SLA.0000000000001177</pmc-comment>
<abstract><sec id="S1"><title>Objective</title><p id="P1">To evaluate complications after post-mastectomy breast reconstruction, particularly in the setting of adjuvant radiotherapy.</p></sec><sec id="S2"><title>Summary-Background Data</title><p id="P2">Most studies of complications after breast reconstruction have been conducted at centers of excellence; relatively little is known about complication rates in radiated patients treated in the broader community. This information is relevant for breast cancer patients' decision-making.</p></sec><sec id="S3"><title>Methods</title><p id="P3">Using the claims-based MarketScan database, we described complications in 14,894 women undergoing mastectomy for breast cancer from 1998-2007 who received immediate autologous reconstruction (n=2637), immediate implant-based reconstruction (n=3007), or no reconstruction within the first two postoperative years (n=9250). We used a generalized estimating equation to evaluate associations between complications and radiotherapy over time.</p></sec><sec id="S4"><title>Results</title><p id="P4">Wound complications were diagnosed within the first two postoperative years in 2.3% of patients without reconstruction, 4.4% with implants, and 9.5% with autologous reconstruction (p<0.001). Infection was diagnosed within the first two postoperative years in 12.7% of patients without reconstruction, 20.5% with implants, and 20.7% with autologous reconstruction (p<0.001). 5219 (35%) women received radiation. Radiation was not associated with infection in any surgical group within the first six months but was associated with an increased risk of infection in months 7-24 in all three groups (each p<0.001). In months 7-24, radiation was associated with higher odds of implant removal in patients with implant reconstruction (OR 1.48, p<0.001) and fat necrosis in those with autologous reconstruction (OR=1.55; P=0.01).</p></sec><sec id="S5"><title>Conclusions</title><p id="P5">Complication risks after immediate breast reconstruction differ by approach. Radiation therapy appears to modestly increase certain risks, including infection and implant removal.</p></sec></abstract></article-meta></front></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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