Abstract
The quality of the recipient vessel is critical for good outcomes after microsurgical breast reconstruction, and damage to the recipient vessels should be minimized. Radiation therapy (RTx) and chemotherapy (CTx) are widely used as adjuvant treatments for breast cancer. They may result in changes in recipient vessels for microsurgical breast reconstruction. Therefore, in this study, we evaluated the changes in recipient vessels for breast reconstruction after adjuvant treatment for breast cancers. Overall, 167 patients with unilateral breast cancer who underwent surgical resection between 2017 and 2021 were selected. Notably, 33 of these patients received only mastectomy without adjuvant treatment (Group A), 44 received only adjuvant RTx (Group B), 43 received only adjuvant CTx (Group C), 47 patients received both adjuvant CTx and RTx (Group D). Using preoperative and postoperative computed tomography (CT) angiography, the vessel diameters of the thoracodorsal artery (TDA) and the internal mammary artery (IMA) on the affected and unaffected sides were measured, and differences in vessel diameters between the two sides and characteristics of each group were analyzed. The diameter of affected vessels (TDA and IMA) significantly decreased in groups B and D compared with the changes in vessel diameters on the unaffected side (p < 0.001). However, there was no significant difference in the diameter of vessels in groups A and C (Group A: p = 0.644, Group B: p = 0.367). Therefore, the diameter of recipient vessels for microsurgical breast reconstruction significantly decreased when RTx was performed postoperatively. Thus, plastic surgeons conducting delayed breast reconstruction must thoroughly understand the changes in recipient vessels associated with adjuvant treatment. Consequently, the preoperative consideration of these possibilities enables plastic surgeons to provide patients with accurate information about the risks associated with surgery, ensuring that informed decisions are made.