Table 3. Reconstructed breast proton beam therapy: Adverse reconstruction outcomes published 2000 - 2022 according to proton beam therapy type.
| Author and year of publication | Median follow up (months) | No.recon. | Adverse reconstruction outcomes | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Infection | Capsular contraction | Prosthetic reconstruction | Autologous reconstruction | |||||||||||
| Revised | Removed | Revised | Replaced | |||||||||||
| Affected/assessed | % | Affected/assessed | % | Affected/assessed | % | Affected/assessed | % | Affected/assessed | % | Affected/assessed | % | |||
| Scattering (1 reconstruction outcome) | ||||||||||||||
| Bradley 2016* | 20 | 4 | 1/4 | 25 | – | – | – | – | – | – | – | – | – | – |
| Scattering or scanning (63 reconstruction outcomes) | ||||||||||||||
| Jimenez 2020† | – | 54 | 2/54 | 4 | 14/54 | 26 | 1/54 | 2 | 16/54 | 30 | – | – | – | – |
| Jimenez 2019 | 55 | 53 | – | – | 12/51 | 24 | 12/51 | 24 | 5/51 | 10 | – | – | 1/2 | 50 |
| Subtotal | – | 107 | 2/54 | 4 | 26/105 | 25 | 13/105 | 12 | 21/105 | 20 | – | – | 1/2 | 50 |
| Scanning (77 reconstruction outcomes) | ||||||||||||||
| Mullikin 2020* | 18 | 66 | 2/66 | 3 | – | – | – | – | – | – | – | – | – | – |
| Gergelis 2021 | – | 62 | – | – | – | – | – | – | – | – | – | – | – | – |
| Nichols 2020† | 14 | 57 | – | – | 4/54 | 7 | – | – | 11/54 | 20 | 0/3 | 0 | – | – |
| Smith 2019 | 19 | 51 | 16/51 | 31 | 1/51 | 2 | – | – | 8/51 | 16 | – | – | – | – |
| Verma 2017 | 16 | 31 | – | – | – | – | – | – | – | – | – | – | – | – |
| DeCesaris 2021† | 5 | 29 | – | – | – | – | – | – | 2/29 | 7 | 1/29 | 3 | – | – |
| Luo 2019 | 35 | 26 | 1/25 | 4 | 6/25 | 24 | 2/25 | 8 | 3/26 | 12 | – | – | – | – |
| Naoum 2022†‡ | – | 17 | – | – | 8/17 | 47 | – | – | 9/17 | 53 | – | – | – | – |
| Giap 2017 | 19 | 5 | – | – | – | – | – | – | – | – | – | – | – | – |
| Anderson 2021†§ | – | 4 | – | – | 2/6 | 33 | – | – | 1/4 | 25 | – | – | – | – |
| Subtotal | – | 348 | 19/142 | 13 | 21/153 | 14 | 2/25 | 8 | 34/181 | 19 | 1/32 | 3 | – | – |
| Total (all PBT types) | – | 459 | 22/200 | 11 | 47/258 | 18 | 15/130 | 12 | 55/286 | 19 | 1/32 | 3 | 1/2 | 50 |
*
Reported severe infections. For all other studies, infections were grade unspecified.
†
Studies investigating proton beam therapy to the reconstructed breast only. Other studies reported outcomes in some patients with breast reconstructions and some without.
‡
Capsular contraction was defined as requiring capsulotomy. Capsular contraction was not defined in the other studies.
§
No. affected/assessed for capsular contraction were extracted from abstract where 6 patients with this outcome were reported upon.
Abbreviations: No.=number, recon=reconstructed breast. “-“=not specified.