Groupe pour L'Avancement de la Microchirurgie Canada (GAM): 28th Annual Meeting
Bibliographic record
Abstract
Previous reports on DIEP or TRAM flap breast reconstruction and post-reconstructive radiation therapy (RT) lead to recommendations that reconstructive surgery should be delayed until RT is complete.This recommendation leads to many patients being offered delayed reconstruction.We reviewed our series of DIEP breast reconstructions that subsequently received RT.METHODS: Retrospective review was performed using the University of Manitoba's Database.Patients who underwent DIEP breast reconstruction and postoperative RT were included.RESULTS: 455 patients underwent a DIEP flap reconstruction over a two-year period.14 patients met our criteria.Average age was 45 (30-65).Cancer types were invasive ductal (n=12), inflammatory and infiltrating papillary (n=1).Average BMI was 24.3 (20-34).Average follow up time post radiation therapy was 12 months (3-24 months).Eight women had RT to the right breast and six had RT to the left.Two women had bilateral reconstruction.There was no documentation of fat necrosis by the two surgeons.One patient had mild volume loss.One patient had revision surgery post RT.Two women who had SLN biopsy scars revisions had minor infections, requiring dressing changes and oral antibiotics.One patient had repeat nipple reconstruction due to loss of projection.CONCLUSIONS: Women undergoing immediate breast reconstruction with a free DIEP showed no evidence of significant fat necrosis due to RT.We suggest that the degree of fat necrosis is determined by the initial perfusion characteristics of the flap and postoperative RT is not an independent variable for determining significant fat necrosis rates.The potential for post-operative RT should not relegate the patient to a delayed reconstruction.LEARNING OBJECTIVES: To learn about effects of RT on DIEP flaps, and show its viability as a treatment option. 02
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.004 | 0.026 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".