Radiology, Vol 200, 621-625, Copyright © 1996 by Radiological Society of North America
Capsular contracture after lumpectomy and radiation therapy in patients who have undergone uncomplicated bilateral augmentation mammoplasty
RJ Mark, RP Zimmerman and JM Greif
Department of Radiation Oncology, University of California, San Diego, USA.
PURPOSE: To assess complications and cosmesis in patients with breast
cancer who underwent lumpectomy and radiation therapy and who previously
underwent uncomplicated bilateral augmentation mammoplasty. MATERIALS AND
METHODS: Twenty-one patients (aged 36-70 years; median age, 50 years) with
breast cancer who had previously undergone bilateral breast augmentation
without complications underwent ipsilateral lumpectomy and radiation
therapy. Radiation therapy was delivered to the augmented breast in opposed
tangential fields with a 4- or 6-MV linear accelerator. The tangential
fields received an average radiation dose of 5,021 cGy (range, 4,500-5,600
cGy), with an average fraction of 187 cGy (range, 180- 200 cGy). Sixteen
patients received an additional 1,000-2,000-cGy boost to the surgical bed
with a 9-18-MeV electron beam. Follow-up was 4-48 months (median, 22
months). RESULTS: At the last follow-up examination, 18 (86%) of the 21
patients were free of disease. Twelve patients had capsular contracture
(57%). Seven patients underwent attempted surgical repair of capsular
contracture. Twelve patients (57%) reported fair to poor cosmesis. The
radiation dose, the location of the implant, the type of implant, and
systemic therapy were not correlated with poor cosmesis. CONCLUSION:
Lumpectomy and radiation therapy in patients with breast cancer who have
previously undergone augmentation mammoplasty result in a high prevalence
of capsular contracture and suboptimal cosmesis.
