J Breast Cancer.  2016 Mar;19(1):68-75. 10.4048/jbc.2016.19.1.68.

Oncologic Safety of Immediate Breast Reconstruction for Invasive Breast Cancer Patients: A Matched Case Control Study

• Park SH
• Han W
• Yoo TK
• Lee HB
• Jin US
• Chang H
• Minn KW
• Noh DY

• KMID: 2176323
• DOI: http://doi.org/10.4048/jbc.2016.19.1.68

Abstract

PURPOSE
The purpose of this study was to compare locoregional recurrence-free survival (LRFS) and disease-free survival (DFS) between patients undergoing mastectomy and immediate breast reconstruction (IBR) and those undergoing mastectomy alone.
METHODS
A retrospective review of patients who underwent mastectomy and immediate breast reconstruction for resectable invasive breast cancer between 2002 and 2010 at a single center was conducted. These cases were matched to patients who underwent mastectomy alone in the same time period, performed by 1:2 matching. Matching control variables included age, tumor size, axillary lymph node metastasis, and estrogen receptor status. Overall, 189 patients were identified in the IBR group, and 362 patients were matched to this group.
RESULTS
In the IBR group, 75 patients (39.7%) underwent conventional total mastectomy, 78 (41.3%) underwent skin-sparing mastectomy (SSM), and 36 (19.0%) underwent nipple-sparing mastectomy (NSM). The IBR group was significantly younger than the control group (41.9 and 45.1 years, respectively) (p=0.032), in spite of matching between three age groups. The DFS rates were similar between the IBR group and mastectomy alone group, at 92.0% and 89.9%, respectively, at 5-year follow-up (log-rank test, p=0.496). The 5-year LRFS was 96.2% in the IBR group and 96.4% in the mastectomy alone group (log-rank test, p=0.704), similar to data from previous reports. Subgroup analyses for SSM or NSM patients showed no differences in LRFS and DFS between the two groups. Additionally, in stage III patients, IBR did not cause an increase in recurrence.
CONCLUSION
IBR after mastectomy, including both SSM and NSM, had no negative impact on recurrence or patient survival, even in patients with advanced disease.

Keyword

Locoregional neoplasm recurrence; Mammaplasty; Mastectomy; Matched case-control study

MeSH Terms

Breast Neoplasms*
Breast*
Case-Control Studies*
Disease-Free Survival
Estrogens
Female
Follow-Up Studies
Humans
Lymph Nodes
Mammaplasty*
Mastectomy
Mastectomy, Simple
Neoplasm Metastasis
Neoplasm Recurrence, Local
Recurrence
Retrospective Studies
Estrogens

Figure

• 

  Figure 1 Recurrence-free survival in all patients. (A) Disease-free survival in the immediate reconstruction group (n=189) and the mastectomy alone group (n=362). (B) Locoregional recurrence-free survival in the immediate reconstruction group (n=189) and the mastectomy alone group (n=362). IBR=immediate breast reconstruction.

• 

  Figure 2 Recurrence-free survival in skin-sparing mastectomy (SSM) or nipple-sparing mastectomy (NSM) group. (A) Disease-free survival in the immediate reconstruction group with SSM or NSM group (n=114) and a matched control group (n=191). (B) Locoregional recurrence-free survival in the immediate reconstruction group undergoing either SSM or NSM (n=114) and a matched control group (n=191). IBR=immediate breast reconstruction.

• 

  Figure 3 Recurrence-free survival in patients with stage III cancer. (A) Disease-free survival in the immediate reconstruction group with stage III cancer (n=22) and a matched control group (n=43). (B) Locoregional recurrence-free survival in the immediate reconstruction group with stage III cancer (n=22) and a matched control group (n=43). IBR=immediate breast reconstruction.

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