Long-term oncologic safety of immediate reconstructive surgery in patients with invasive breast cancer: a retrospective matched-cohort study

World Journal of Surgical Oncology

Ming Niu¹  Jing Xiong¹  Yang Wu¹  Qiqi Wu¹  Dalin Li¹  Shanshan Sun¹  Jiguang Han¹  Sihang Zhang²  Rui Huang³  Sai Luo⁴  Haiqian Xu⁴  Yanni Song⁵  Lijun Hao⁶ 

[1] Department of Breast Surgery, Harbin Medical University Cancer Hospital, 150 Haping Road, 150081, Harbin, China;Department of Epidemiology and Bio-Statistics, School of Public Health, Peking University Health Science Center, 38 Xueyuan Road, Haidian District, Beijing, China;Department of General Surgery, The Second Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, 150086, Harbin, China;Department of Plastic and Cosmetic Surgery, The First Affiliated Hospital of Harbin Medical University, 141 Yiman Road, 150010, Harbin, China;Department of Plastic and Cosmetic Surgery, The First Affiliated Hospital of Harbin Medical University, 141 Yiman Road, 150010, Harbin, China;Department of Breast Surgery, Harbin Medical University Cancer Hospital, 150 Haping Road, 150081, Harbin, China;Department of Pathology, Tianjin Medical University Cancer Hospital, 1 Huanhu Xi Road, 300060, Tianjin, China;Department of Plastic and Cosmetic Surgery, The First Affiliated Hospital of Harbin Medical University, 141 Yiman Road, 150010, Harbin, China;Sino-Russian Medical Research Center, Heilongjiang Academy of Medical Sciences, 157 Baojian Road, Harbin, China;Northern (China) Translational Medicine Research and Cooperation Center, Heilongjiang Academy of Medical Sciences, 157 Baojian Road, Harbin, China;

关键词: Breast cancer;    Breast reconstruction;    Breast conservation surgery;    Modified radical mastectomy;    Patient satisfaction;    Prognosis;   

DOI  :  10.1186/s12957-021-02450-9

来源: Springer

【 摘 要 】

ObjectiveImmediate reconstruction (IR) is a safe and effective surgical treatment for patients with breast cancer. We aimed to assess the prognosis, aesthetic outcomes, and patient satisfaction of IR compared with breast conservation surgery (BCS) and total mastectomy (TM).MethodsThis retrospective matched-cohort study was conducted between May 2005 and December 2014. We established two cohorts according to the tumor (T) size of breast cancer. In the T≤3cm group, cases (IR) and controls (BCS or TM) were matched for age, pathological tumor size, and pathologic nodal status in a 1:1:1 ratio. In the T>3cm group, cases (IR) and controls (TM) were matched with the same factors and ratio. The primary outcome was the 5-year disease-free survival (DFS). The secondary outcome was patient satisfaction and quality of life.ResultsA total of 12,678 breast cancer patients were assessed for eligibility, of which 587 were included (T≤3 cm group: 155 IR vs 155 BCS vs 155 TM; T>3cm group: 61 IR vs 61 TM). In the T≤3 cm cohort, patients who underwent IR had no difference compared with those who underwent BCS or TM regarding the 5-year DFS (P=0.539); however, an improved aesthetic satisfaction, psychosocial, and sexual well-being were achieved in the IR group (P<0.001). In the T>3 cm cohort, the IR group had a worse median 5-year DFS (P=0.044), especially for Her2+ or triple-negative breast carcinoma (TNBC) subtypes compared with the TM group.ConclusionsIR improves aesthetic satisfaction, psychosocial, and sexual well-being for breast cancer patients with T≤3 cm. For patients with T > 3 cm invasive breast cancer, TM is superior to IR as it predicts a better 5-year DFS.

【 授权许可】

CC BY