Short- and long-term outcomes of immediate breast reconstruction surgery after neoadjuvant chemotherapy.
Breast cancer
Complications
Immediate breast reconstruction
Neoadjuvant chemotherapy
Journal
Surgery today
ISSN: 1436-2813
Titre abrégé: Surg Today
Pays: Japan
ID NLM: 9204360
Informations de publication
Date de publication:
Jan 2022
Jan 2022
Historique:
received:
11
12
2020
accepted:
22
04
2021
pubmed:
6
6
2021
medline:
2
2
2022
entrez:
5
6
2021
Statut:
ppublish
Résumé
Immediate breast reconstruction (IBR) is a standard option for breast cancer patients, although its utility in patients with advanced breast cancer requiring neoadjuvant chemotherapy (NAC) is debatable. We assessed the short-term complications and long-term prognosis of IBR after NAC. We retrospectively analyzed 1135 patients with IBR and/or NAC between 2010 and 2018, 43 of whom underwent IBR after NAC. Twenty-five patients underwent reconstruction with a tissue expander (TE) followed by silicon breast implantation, 5 with a latissimus dorsi muscle transfer flap, and 13 with a deep inferior epigastric perforator flap. Complete surgical resection with a free margin confirmed by a pathological assessment was achieved in all patients. The evaluation of the short-term complications indicated no cases of total flap necrosis, two cases of partial flap necrosis, and one case of wound infection. Only one case required postponement of subsequent therapy due to partial flap necrosis. A long-term evaluation indicated no local recurrence, although distant metastasis was observed in 4 cases, 3 patients died, and TE removal after post-mastectomy radiotherapy (PMRT) was performed in 2 of 11 TE cases. IBR may be a viable option in patients with advanced breast cancer who achieve complete surgical resection after NAC.
Identifiants
pubmed: 34089365
doi: 10.1007/s00595-021-02316-3
pii: 10.1007/s00595-021-02316-3
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
129-136Informations de copyright
© 2021. Springer Nature Singapore Pte Ltd.
Références
Wolmark N, Wang J, Mamounas E, Bryant J, Fisher B. Preoperative chemotherapy in patients with operable breast cancer: nine-year results from National Surgical Adjuvant Breast and Bowel Project B-18. J Natl Cancer Inst Monogr. 2001;30:96–102.
doi: 10.1093/oxfordjournals.jncimonographs.a003469
NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) Breast Cancer Vesion 4. 2021; April 28, 2021
von Minckwitz G, Untch M, Blohmer JU, Costa SD, Eidtmann H, Fasching PA, et al. Definition and impact of pathologic complete response on prognosis after neoadjuvant chemotherapy in various intrinsic breast cancer subtypes. J Clin Oncol. 2012;30(15):1796–804.
doi: 10.1200/JCO.2011.38.8595
Kurebayashi J, Miyoshi Y, Ishikawa T, Saji S, Sugie T, Suzuki T, et al. Clinicopathological characteristics of breast cancer and trends in the management of breast cancer patients in Japan: based on the Breast Cancer Registry of the Japanese Breast Cancer Society between 2004 and 2011. Breast Cancer. 2015;22(3):235–44. https://doi.org/10.1007/s12282-015-0599-6 .
doi: 10.1007/s12282-015-0599-6
pubmed: 25758809
Iwata H, Saji S, Ikeda M, Inokuchi M, Uematsu T, Toyama T, et al. The Japanese Breast Cancer Society Clinical Practice Guidelines, 2018 edition: the tool for shared decision making between doctor and patient. Breast Cancer. 2020;27(1):1–3.
doi: 10.1007/s12282-019-01021-x
Mehrara BJ, Santoro TD, Arcilla E, Watson JP, Shaw WW, Da Lio AL. Complications after microvascular breast reconstruction: experience with 1195 flaps. Plast Reconstr Surg. 2006;118(5):1100–9 (Discussion 1110–1).
doi: 10.1097/01.prs.0000236898.87398.d6
Allué Cabañuz M, Arribas Del Amo MD, Gil Romea I, Val-Carreres Rivera MP, Sousa Domínguez R, Güemes Sánchez AT. Direct-to-implant breast reconstruction after neoadjuvant chemotherapy: a safe option? Cir Esp. 2019;97(10):575–81.
doi: 10.1016/j.ciresp.2019.07.003
Selber JC, Kurichi JE, Vega SJ, Sonnad SS, Serletti JM. Risk factors and complications in free TRAM flap breast reconstruction. Ann Plast Surg. 2006;56(5):492–7.
doi: 10.1097/01.sap.0000210180.72721.4a
Mitchem J, Herrmann D, Margenthaler JA, Aft RL. Impact of neoadjuvant chemotherapy on rate of tissue expander/implant loss and progression to successful breast reconstruction following mastectomy. Am J Surg. 2008;196(4):519–22.
doi: 10.1016/j.amjsurg.2008.06.016
Liu Y, Mori H, Hata Y. Does neoadjuvant chemotherapy for breast cancer increase complications during immediate breast reconstruction? J Med Dent Sci. 2009;56(1):55–60.
pubmed: 19697519
Azzawi K, Ismail A, Earl H, Forouhi P, Malata CM. Influence of neoadjuvan chemotherapy on outcomes of immediate breast reconstruction. Plast Reconstr Surg. 2010;126(1):1–11.
doi: 10.1097/PRS.0b013e3181da8699
Abt NB, Flores JM, Baltodano PA, Sarhane KA, Abreu FM, Cooney CM, et al. Neoadjuvant chemotherapy and short-term morbidity in patients undergoing mastectomy with and without breast reconstruction. JAMA Surg. 2014;149(10):1068–76.
doi: 10.1001/jamasurg.2014.1076
Aurilio G, Bagnardi V, Graffeo R, Nole F, Petit JY, Locatelli M, et al. Does immediate breast reconstruction after mastectomy and neoadjuvant chemotherapy influence the outcome of patients with non-endocrine responsive breast cancer? Anticancer Res. 2014;34(11):6677–83.
pubmed: 25368274
Toh U, Takenaka M, Iwakuma N, Akagi Y. Clinical outcomes of patients after nipple-sparing mastectomy and reconstruction based on the expander/implant technique. Surg Today. 2020. https://doi.org/10.1007/s00595-020-02175-4 .
doi: 10.1007/s00595-020-02175-4
pubmed: 33185799
pmcid: 8141482
Terao Y, Taniguchi K, Fujii M, Moriyama So. Postmastectomy radiation therapy and breast reconstruction with autologous tissue. Breast Cancer. 2017;24:505–10. https://doi.org/10.1007/s12282-017-0760-5 .
doi: 10.1007/s12282-017-0760-5
pubmed: 28229358