S328
Clinical - Breast
ESTRO 2026
Results: Fifty patients were evaluated, 29/50 (58%) treated with PART technique and 21/50 (42%) treated with conventional radiotherapy technique. Total prescribed dose was 40.05 gy delivered in 15 fractions. Table 1 shows the results of chi-square analysis, the risk values and the p-values of multivariate analysis. Overall 54% of patients experienced any grade of capsular contraction and 28% of implant rippling/waving. Only PART technique showed to be associated to lower rate of capsular contractures and implants’rippling/waving (p=<0.001, reduction of the risk of 78% for capsular contraction). This protective effect was confirmed on multivariate analysis (p=0.002 for capsular contractures). No protective effect was showed for other complications except that for implant rippling/waving even if the rate of overall observed events in patients treated with PART technique was low (1 event, 3.4%).McNemar’s analysis confirmed these findings, showing a highly significant reduction in capsular contracture (p= 0.0005).
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Clinical Outcomes of Prosthesis Avoidance RadioTherapy (PART) Following Implant-Based Breast Reconstruction: A Retrospective Cohort Study. Sara Reina 1 , Edy Ippolito 2 , Barbara Cagli 3 , Lucrezia Toppi 1 , Vera Cirnigliaro 1 , Salvatore Minuti 2 , Andrea Aniello Cimmino 4 , Andrea Tarantino 4 , Alessandra Carlone 4 , Paola Martucci 1 , Michele Fiore 2 , Carlo Greco 2 , Paolo Persichetti 3 , Vittorio Altomare 5 , Sara Ramella 2 1 Operative Research Unit of Radiation Oncology, Fondazione Policlinico Universitario Campus Bio- Medico, Rome, Italy. 2 Research Unit of Radiation Oncology, Università Campus Bio-Medico di Roma, Rome, Italy. 3 Department of Plastic, Reconstructive and Aesthetic Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy. 4 Department of Plastic, Reconstructive and Aesthetic Surgery, Università Campus Bio-Medico di Roma, Rome, Italy. 5 Breast Unit, Università Campus Bio- Medico di Roma, Rome, Italy Purpose/Objective: Post-mastectomy radiation therapy (PMRT) is relevant for locoregional control in breast cancer treatment. However, it can lead to increased complications in implant-based reconstruction, which can negatively affect a patient's quality of life. Prosthesis Avoidance RadioTherapy (PART) is a technique that aligns with ESTRO-ACROP recommendations on target volume delineation in patients undergoing PMRT and partially spares the implant located within the clinical target volume. This study aims to evaluate the effects of the PART technique on reconstruction outcomes. Material/Methods: We selected from a retrospective ethics committee- approved study database including patients undergoing neoadjuvant chemotherapy followed by mastectomy and implant based reconstruction (both immediate or delayed) treated at our institution from January 2010 to December 2023. Patients were treated with conventional PMRT technique or with PART. Chi- square test was used to analyze differences regarding the incidence of reconstruction complications such as capsular contractures, implant rippling/waving, seromas, infection, implant exposure, wound dehiscence, hematoma and, prosthesis breakage and prosthesis removal or replacement. Indipendent variables tested were: PART, reconstruction type (one stage-two stage) , active smoking (yes/no) and BMI (>25 vs ≤ 25). Subsequently we conducted a multivariate analysis fitting a generalized linear models including in the model all the above mentioned variables. Finally McNemar’s test was conducted matching on key variables to isolate the effect of PART technique.
Conclusion: PART technique seems to be effective in preventing implant capsular contractures related to PMRT. This noteworthy result warrants further correlation with the dosimetric parameters of the radiotherapy plans and validation in a larger patient cohort. References: Kaidar-Person O, Vrou Offersen B, Hol S, Arenas M, Aristei C, Bourgier C, Cardoso MJ, Chua B, Coles CE, Engberg Damsgaard T, Gabrys D, Jagsi R, Jimenez R, Kirby AM, Kirkove C, Kirova Y, Kouloulias V, Marinko T, Meattini I, Mjaaland I, Nader Marta G, Witt Nystrom P, Senkus E, Skyttä T, Tvedskov TF, Verhoeven K, Poortmans P. ESTRO ACROP consensus guideline for target volume delineation in the setting of postmastectomy radiation therapy after implant- based immediate reconstruction for early stage breast cancer. Radiother Oncol. 2019 Aug;137:159-166. doi: 10.1016/j.radonc.2019.04.010. Epub 2019 May 17. PMID: 31108277. Keywords: Post-Mastectomy Radiation Therapy
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