Oncological safety of autologous breast reconstruction after mastectomy for invasive breast cancer

BMC Cancer

Annouschka Laenen¹  Ann Smeets²  Hans Wildiers²  Giuseppe Floris²  Katrien Van Calster²  Ines Nevelsteen²  Joachim Geers²  Marc Vandevoort²  Gerd Fabre² 

[1]Department of Public Health and Primary Care, Interuniversity Institute of Biostatistics and Statistical Bioinformatics, University Hospitals Sint-Raphaël

[2]Multidisciplinary Breast Centre, University Hospitals Leuven

关键词: Autologous breast reconstruction;    Invasive breast cancer;    Tumour dormancy;    Surgical stress;    Metastases;   

DOI  :  10.1186/s12885-018-4912-6

来源: DOAJ

【 摘 要 】

Abstract Background The number of patients requesting autologous breast reconstruction (ABR) after mastectomy for breast cancer has increased over the past decades. However, concern has been expressed about the oncological safety of ABR. The aim of our study was to assess the effect of ABR on distant relapse. Methods In this retrospective cohort study, data was analysed from patients who underwent mastectomy for invasive breast cancer in University Hospitals Leuven between 2000 and 2011. In total, 2326 consecutive patients were included, 485 who underwent mastectomy with ABR and 1841 who underwent mastectomy alone. The risk of relapse in both groups was calculated using a Cox proportional hazards analysis, adjusted for established prognostic factors. ABR was considered as a time-dependent variable. Additionally, the evolution of the risk over follow-up time was calculated. Results With a median follow-up of 68 months, 8% of patients in the reconstruction group developed distant metastases compared to 15% in the mastectomy alone group (univariate HR 0.70, 95% CI 0.50–0.97, p = 0.0323). However, after adjustment for potential confounding factors in a Cox multivariable analysis, the risk of distant relapse was no longer significantly different between groups (multivariate HR 0.82, 95% CI 0.55–1.22, p = 0.3301). Moreover, the risk of metastasis after reconstruction was not time-dependent. Conclusions These findings suggest that there is no effect of ABR on distant relapse rate and thus that ABR is an oncological safe procedure. The rate of local recurrence was too low to make any significant conclusions.

【 授权许可】

Unknown