Comparison of complications and satisfaction between immediate and delayed prosthetic breast reconstruction in postoperative radiotherapy patients

ZHANG Yu; JIN Yuting; WANG Jiali; CHEN Xiaoyu; MENG Cuiling; MA Jun

doi:10.3969/j.issn.1009-0460.2026.02.013

Abstract：Objective To compare the incidence of complications and patient satisfaction between immediate prosthetic breast reconstruction and delayed prosthetic breast reconstruction in patients undergoing radiotherapy after radical mastectomy for breast cancer,and to analyze the influencing factors of complications.Methods This study is a single-center retrospective investigation.According to the inclusion and exclusion criteria,a total of 96 patients who underwent radical mastectomy,prosthetic breast reconstruction,and postoperative radiotherapy at Jiangsu Provincial Hospital of Traditional Chinese Medicine between January 2019 and November 2023 were included.Based on the timing of breast reconstruction,the patients were divided into the immediate prosthetic breast reconstruction group(immediate reconstruction group,n=58)and the delayed prosthetic breast reconstruction group(delayed reconstruction group,n=38).Complications and satisfaction scores were compared between the two groups,and the influence of related factors on the occurrence of complications was evaluated by logistic regression model.Results There were no statistically significant differences between the two groups in terms of age,menopausal status,TNM stage,neoadjuvant chemotherapy,tumor location,tumor number,molecular subtype,and postoperative radiotherapy field(P＞0.05).Regarding complications,the overall complication rate in the immediate reconstruction group was 32.8％(19/58),comparable to the 28.9％(11/38)in the delayed reconstruction group,with no statistically significant difference(P=0.694).However,the incidence of capsular contracture in the immediate reconstruction group was 20.7％(12/58),significantly higher than the 5.3％(2/38)in the delayed reconstruction group(P=0.036).Univariate analysis suggested that diabetes might be associated with an increased risk of complications(immediate reconstruction group:OR=4.306,P=0.016).There were no statistically significant differences between the two groups in breast satisfaction,psychological well-being,satisfaction with the medical process,or total satisfaction scores(P＞0.05).During the follow-up period,no deaths were observed in either group.One patient in the immediate reconstruction group(1/58,1.72％)developed bone metastasis 32 months after surgery,while two patients in the delayed reconstruction group(2/38,5.26％)developed visceral metastases at 18 months and 46 months after surgery,respectively.There was no statistically significant difference in the overall disease recurrence rate between the two groups(P=0.560).Conclusion For patients undergoing radiotherapy after radical mastectomy for breast cancer,delayed prosthetic reconstruction can reduce the risk of capsular contracture,while the overall incidence of complications and patient satisfaction are similar between the two reconstruction timing strategies.Clinical decision-making should comprehensively weigh these factors based on individual patient circumstances.