Long-Term Outcomes of Immediate Autologous Breast Reconstruction for Breast Cancer Patients.


Journal

The Journal of surgical research
ISSN: 1095-8673
Titre abrégé: J Surg Res
Pays: United States
ID NLM: 0376340

Informations de publication

Date de publication:
07 2020
Historique:
received: 28 05 2019
revised: 08 01 2020
accepted: 16 01 2020
pubmed: 1 3 2020
medline: 15 9 2020
entrez: 1 3 2020
Statut: ppublish

Résumé

There is limited information on the oncological outcomes of immediate autologous breast reconstruction in the Asian population. This study aimed to evaluate the oncological outcomes of immediate one-stage autologous breast reconstruction using a free perforator flap for breast cancer patients at a single institution in Japan. We retrospectively reviewed 239 patients who underwent immediate one-stage autologous breast reconstruction using a free perforator flap after skin- or nipple-sparing mastectomy. The whole breast was pathologically analyzed in 5-mm sections. Clinical and pathological data were collected from medical records. For tumor stage among the 239 patients, 101 (42.3%) had stage 0, 127 (53.1%) had stage I and II, and 11 (4.6%) had stage III. Twenty-three patients (9.6%) had margin involvement in the surgical specimen. Adjuvant chemotherapy was performed in 75 patients (30%), and endocrine therapy was administered in 153 patients (64%). Radiation therapy was performed in 15 patients (6.3%) because of multiple lymph node metastases or margin involvement. With a median follow-up time of 73 mo, local recurrence was found in 3.3%, distant metastases in 2.5%, and contralateral breast cancer in 3.7%. All patients with local recurrence did not receive radiation therapy as adjuvant treatment. Among the patients who underwent immediate one-stage autologous reconstruction after breast surgery, 3.3% had local recurrence. For patients with margin involvement, radiation therapy is a promising option.

Sections du résumé

BACKGROUND
There is limited information on the oncological outcomes of immediate autologous breast reconstruction in the Asian population. This study aimed to evaluate the oncological outcomes of immediate one-stage autologous breast reconstruction using a free perforator flap for breast cancer patients at a single institution in Japan.
METHODS
We retrospectively reviewed 239 patients who underwent immediate one-stage autologous breast reconstruction using a free perforator flap after skin- or nipple-sparing mastectomy. The whole breast was pathologically analyzed in 5-mm sections. Clinical and pathological data were collected from medical records.
RESULTS
For tumor stage among the 239 patients, 101 (42.3%) had stage 0, 127 (53.1%) had stage I and II, and 11 (4.6%) had stage III. Twenty-three patients (9.6%) had margin involvement in the surgical specimen. Adjuvant chemotherapy was performed in 75 patients (30%), and endocrine therapy was administered in 153 patients (64%). Radiation therapy was performed in 15 patients (6.3%) because of multiple lymph node metastases or margin involvement. With a median follow-up time of 73 mo, local recurrence was found in 3.3%, distant metastases in 2.5%, and contralateral breast cancer in 3.7%. All patients with local recurrence did not receive radiation therapy as adjuvant treatment.
CONCLUSIONS
Among the patients who underwent immediate one-stage autologous reconstruction after breast surgery, 3.3% had local recurrence. For patients with margin involvement, radiation therapy is a promising option.

Identifiants

pubmed: 32113041
pii: S0022-4804(20)30065-2
doi: 10.1016/j.jss.2020.01.010
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

78-84

Informations de copyright

Copyright © 2020 Elsevier Inc. All rights reserved.

Auteurs

Akimitsu Yamada (A)

Department of Gastroenterological Surgery, Yokohama City University School of Medicine, Kanazawa, Yokohama, Kanagawa, Japan; Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Minami, Yokohama, Kanagawa, Japan.

Kazutaka Narui (K)

Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Minami, Yokohama, Kanagawa, Japan. Electronic address: nr1@gc5.so-net.ne.jp.

Toshihiko Satake (T)

Department of Plastic Surgery, Yokohama City University Medical Center, Minami, Yokohama, Kanagawa, Japan.

Shoko Adachi (S)

Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Minami, Yokohama, Kanagawa, Japan.

Mikiko Tanabe (M)

Department of Pathology, Yokohama City University Medical Center, Minami, Yokohama, Kanagawa, Japan.

Daisuke Shimizu (D)

Department of Breast Surgery, Yokohama City Minato Red Cross Hospital, Naka, Yokohama, Kanagawa, Japan.

Takashi Ishikawa (T)

Department of Breast Surgery and Oncology, Tokyo Medical University, Shinjuku, Tokyo, Japan.

Itaru Endo (I)

Department of Gastroenterological Surgery, Yokohama City University School of Medicine, Kanazawa, Yokohama, Kanagawa, Japan.

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