Breast Cancer Breast Reconstruction Vs.modified Radical Mastectomy:Dosimetric Comparison And Effect Of Radiotherapy On Breast Reconstruction

PurposeCompare the radiotherapy dosimetry of modified radical mastectomy combined with breast reconstruction and simple modified radical mastectomy,and compare the radiotherapy complications of the two.At the same time,the impact of radiotherapy on breast reconstruction was analyzed to provide a basis for formulating individualized treatment plans for patients.MethodA total of 82 female patients who underwent improved radical mastectomy for breast cancer from 2016 to 2019 were collected,including 51 cases of improved radical mastectomy combined with breast reconstruction,and 31 cases of simple radical mastectomy.Divided into two groups according to whether to undergo breast reconstruction:breast reconstruction+radiation therapy in 28 cases,modified radical surgery+radiation therapy in 31 cases,all received intensity modulated radiation therapy,radiation treatment plan:DT:PTVCTV1(upper and lower clavicle lymph nodes):50cgy/25f/5w;PTVCTV2(chest wall):50Gy/25f/5w.The target area conformity index,uniformity index,target area coverage,and the doses to which organs were endangered were compared,and the adverse effects of radiation therapy were compared between the two groups of patients.At the same time,breast reconstruction was divided into two groups according to the presence or absence of radiation therapy,28 cases received radiotherapy and 23 cases did not receive radiotherapy.The effect of radiotherapy on the aesthetics of reconstructed breasts was compared.Results1.Regarding the target uniformity index(HI),conformal index(CI),and radiotherapy target parameters Dmean,D2,D98,V95,V105,there was no statistical difference between the primary breast reconstruction group and the modified radical mastectomy alone(P>0.05).2.Regarding organ-endangered patients’ lungs,for the parameters Dmean,Dmax,V5,V20,V30,and V40,the radiotherapy plan of the primary breast reconstruction group is better than that of the modified radical mastectomy group with statistical differences;for the parameter V10,primary breast The reconstruction group was slightly better than the modified radical surgery group but there was no statistical difference.3.Regarding the radiation dose and volume of the left and right breast cancer hearts,for the radiotherapy parameters Dmean,Dmax,V10,V20,V30,and V40,the primary breast reconstruction group is slightly better than the modified radical operation group,but the statistics There is no difference.4.There was no significant difference in radiation dermatitis in the one-stage breast reconstruction group and the two groups with modified radical mastectomy alone(P>0.05).After the primary breast reconstruction surgery received radiotherapy,the aesthetics of the reconstructed breast decreased,which was statistically different(P<0.05).ConclusionAlthough the aesthetics of reconstructed breasts after radiotherapy declines,the comparison of radiotherapy dosimetry is not inferior or even better than that of modified radical surgery in terms of protection of the affected lung.Therefore,it is necessary for patients who need postoperative radiotherapy to perform breast reconstruction Advantage.