Arch Plast Surg.  2018 Sep;45(5):432-440. 10.5999/aps.2018.00563.

Impact of hormonal therapy and other adjuvant therapies on contralateral breast volume change after implant-based breast reconstruction

• Park JY
• Chung JH
• Lee HC
• Lee BI
• Park SH
• Yoon ES

• KMID: 2422139
• DOI: http://doi.org/10.5999/aps.2018.00563

Abstract

BACKGROUND
Adjuvant therapy after breast surgery, including tamoxifen or aromatase inhibitors, improves the postoperative outcomes and long-term survival of breast cancer patients. The aim of this study was to determine whether volume changes occurred in the contralateral breast during hormonal or other adjuvant therapies.
METHODS
This study reviewed 90 patients who underwent unilateral breast reconstruction between September 2012 and April 2018 using tissue expanders and a permanent implant after the surgical removal of breast cancer. The volume of the contralateral breast was measured using a cast before the first (tissue expander insertion) and second (permanent implant change) stages of surgery. Changes in breast volume were evaluated to determine whether adjuvant therapy such as hormonal therapy, chemotherapy, and radiation therapy influenced the volume of the contralateral breast.
RESULTS
The group receiving tamoxifen therapy demonstrated a significant decrease in volume compared with the group without tamoxifen (−7.8% vs. 1.0%; P=0.028). The aromatase inhibitor-treated group showed a significant increase in volume compared with those who did not receive therapy (−6.2% vs. 4.5%; P=0.023). There were no significant differences between groups treated with other hormonal therapy, chemotherapy, or radiation therapy.
CONCLUSIONS
Patients who received tamoxifen therapy showed a significant decrease in volume in the contralateral breast, while no significant change in weight or body mass index was found. Our findings suggest that we should choose smaller implants for premenopausal patients, who have a high likelihood of receiving tamoxifen therapy.

Keyword

Surgery, plastic; Reconstructive surgical procedures; Mammaplasty; Hormone antagonists; Tamoxifen

MeSH Terms

Aromatase
Aromatase Inhibitors
Body Mass Index
Breast Neoplasms
Breast*
Drug Therapy
Female
Hormone Antagonists
Humans
Mammaplasty*
Reconstructive Surgical Procedures
Surgery, Plastic
Tamoxifen
Tissue Expansion Devices
Aromatase
Aromatase Inhibitors
Hormone Antagonists
Tamoxifen