CAPSULAR CONTRACTURE AFTER LUMPECTOMY AND RADIATION-THERAPY IN PATIENTS WHO HAVE UNDERGONE UNCOMPLICATED BILATERAL AUGMENTATION MAMMAPLASTY

PURPOSE: To assess complications and cosmesis in patients with breast cancer who underwent lumpectomy and radiation therapy and who previous ly underwent uncomplicated bilateral augmentation mammoplasty. MATERIA LS AND METHODS: Twenty-one patients (aged 36-70 years; median age, 50 years) with breast cancer who had previously undergone bilateral breas t augmentation without complications underwent ipsilateral lumpectomy and radiation therapy. Radiation therapy was delivered to the augmente d breast in opposed tangential fields with a 4- or 6-MV linear acceler ator. The tangential fields received an average radiation dose of 5,02 1 cGy (range, 4,500-5,600 cGy), with an average fraction of 187 cGy (r ange, 180-200 cGy). Sixteen patients received an additional 1,000-2,00 0-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 att empted surgical repair of capsular contracture. Twelve patients (57%) reported fair to poor cosmesis. The radiation dose, the location of th e implant, the type of implant, and systemic therapy were not correlat ed with poor cosmesis. CONCLUSION: Lumpectomy and radiation therapy in patients with breast cancer who have previously undergone augmentatio n mammoplasty result in a high prevalence of capsular contracture and suboptimal cosmesis.