Rib cage deformity during two-stage tissue expander breast reconstruction in patient with previous radiotherapy: a case report

  • Aleš Porčnik University Clinical Centre Ljubljana, Zaloška cesta 2, 1525 Ljubljana, Slovenia
  • Uroš Ahčan University Clinical Centre Ljubljana
Keywords: Radiotherapy, rib cage deformity, tissue expander, CT scan.

Abstract

Patients undergoing two-stage breast reconstruction with tissue expander and a history of previous irradiation are predisposed to a various chest-wall deformations more than non-irradiated patients. If chest-wall depression with/without rib fracture is found intra-operatively, bigger implant should be used, with a subsequent radiologic evaluation. In the future, the development of a new, modified expander with a harder base could minimise such complications.

Downloads

Download data is not yet available.

Author Biographies

Aleš Porčnik, University Clinical Centre Ljubljana, Zaloška cesta 2, 1525 Ljubljana, Slovenia

Aleš Porčnik, MD., Department of Plastic, Reconstructive and Aesthetic Surgery and Burns Unit, University Clinical Centre Ljubljana, Zaloška cesta 2, 1525 Ljubljana, Slovenia, telephone: +38651350216; e-mail: ales.porcnik@gmail.com

Uroš Ahčan, University Clinical Centre Ljubljana

Uroš Ahčan, MD, PhD, professor, Head of Department, Department of Plastic, Reconstructive and Aesthetic Surgery and Burns Unit, University Clinical Centre
Ljubljana, Zaloška cesta 2, 1525 Ljubljana, Slovenia

References

2013 Plastic Surgery Statistic Report [American society of plastic surgery web site]. Available at http://www.plasticsurgery.org/Documents/news-resources/statistics/2013-statistics/plastic-surgery-statistics-full-report-2013.pdf. Accessed December 19, 2014.

Ho AL, Bovill ES, Macadam SA, Tyldesley S, Giang J, Lennox PA. Postmastectomy radiation therapy after immediate two-stage tissue expander/implant breast reconstruction: a University of British Columbia perspective. Plast Reconstr Surg 2014; 134: 1-10.

Kronowitz SJ. Current status of implant-based breast reconstruction in patients receiving postmastectomy radiation therapy. Plast Reconstr Surg 2012; 130: 513-24.

Alani H, Shantour S. Breast reconstruction by tissue expander after radiotherapy: When the skin does not expand, the rib cage is at risk. Eur J Plast Surg 2014; 37: 333-8.

de Wildt R, Tuinder S, van der Hulst RWJ. Substantial chest-wall deformity following tissue expansion after radiotherapy. Eur J Plast Surg 2009; 32: 337-40.

Tseng J, Huang AH, Wong MS, Whetzel TP, Stevenson TR. Rib fractures: a complication of radiation therapy and tissue expansion for breast reconstruction. Plast Reconstr Surg 2010; 125: 65-6.

Tirone L, La Rusca I, Ciccarelli F. Rib fracture as a complication of tissue expansion in breast reconstruction. Plast Reconstr Surg 2010; 126: 2290-1.

Huang AH, Wong MS, Whetzel TP, Stevenson TR. Rib fractures: a complication of radiation therapy and tissue expansion for breast reconstruction. Breast Cancer Res Treat 2007; 106: 1 Suppl: 238.

Ahcan U, Zivec K. Rib fracture after breast reconstruction with tissue expander. Zdrav Vest 2009; 78: 413-6.

Wong S, Kaur A, Back M, Lee KM, Baggarley S, Lu JJ. An ultrasonographic evaluation of skin thickness in breast cancer patients after postmastectomy radiation therapy. Radiat Oncol 2011; 6: 9.

Hirbe A, Morgan EA, Uluçkan Ö, Weilbaecher K. Skeletal Complications of Breast Cancer Therapies. Clin Cancer Res 2006; 12: 20 Suppl: 6309-63.

Overgaard M. Spontaneous radiation-induced rib fractures in breast cancer patients treated with postmastectomy irradiation. A clinical radiobiological analysis of the influence of fraction size and dose-response relationships on late bone damage. Acta Oncol 1988; 27: 117-22.

Monticciolo DL, Sincleair ST, Hajdik RL. Rib Fracture as a Complication of Accelerated Partial Breast Irradiation Diagnosed on MRI. Breast J 2010; 16: 424-7.

Published
2016-02-20
How to Cite
1.
Porčnik A, Ahčan U. Rib cage deformity during two-stage tissue expander breast reconstruction in patient with previous radiotherapy: a case report. ZdravVestn [Internet]. 20Feb.2016 [cited 30Mar.2020];85(1). Available from: https://vestnik.szd.si/index.php/ZdravVest/article/view/1315
Section
Case report, short scientific article