Impact of Chemotherapy and Radiation on Breast Sensation After Immediate Reconstruction
Bibliographic record
Abstract
PURPOSE: This study explores the impact of chemotherapy and radiation therapy (XRT) on breast sensation in patients undergoing mastectomy with immediate reconstruction. METHODS: This prospective study, conducted from 2019 to 2024, focused on patients undergoing mastectomy with immediate implant-based or neurotized deep inferior epigastric perforator (DIEP) flap reconstruction. Neurosensory testing was performed preoperatively and at defined postoperative intervals using a pressure-specified sensory device. Patients were stratified by type of reconstruction and oncologic treatment: neoadjuvant chemotherapy, adjuvant chemotherapy, preoperative XRT, and adjuvant XRT. Sensation scores were compared between each treatment group and its corresponding control group using an unpaired two-sample t test. Subsequently, a mixed-effects backward linear regression model was used to assess the relative impact of each treatment. RESULTS: A total of 291 patients were analyzed, including 154 patients (274 breasts) who underwent implant-based reconstruction and 137 patients (248 breasts) who underwent DIEP flap reconstruction. Neoadjuvant chemotherapy and preoperative XRT were associated with temporary reductions in outer breast sensation at 3 to 12 months postoperatively, whereas adjuvant XRT resulted in widespread and persistent sensory deficits. Adjuvant chemotherapy had no impact on sensation in implant-based reconstructions but was associated with long-term decreased sensation in the outer breast regions of DIEP flap reconstructions. Regression analysis identified adjuvant XRT (β = 13.06), neoadjuvant chemotherapy (β = 5.99), and higher BMI (β = 0.71) as significant risk factors for diminished breast sensation (P = 0.05), whereas neurotized DIEP flap reconstruction (β = -7.82) and a greater time since surgery (β = -1.56) were protective factors (P < 0.001). CONCLUSIONS: These findings highlight the detrimental impacts of adjunctive oncologic therapies, particularly adjuvant XRT, on breast sensation. This information can aid in preoperative counseling and help establish realistic expectations for breast cancer patients considering mastectomy and reconstruction.
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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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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".