Immediate breast reconstruction does not lead to a delay in the delivery of adjuvant chemotherapy

Wilson, Christopher R.; Brown, Iain; Weiller-Mithoff, E.; George, W.D.; Doughty, Julie

doi:10.1016/j.ejso.2004.04.006

Cited by 64 publications

(45 citation statements)

References 13 publications

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“…CT is indicated for both axillary-positive and axillary-negative patients on the basis of high-risk tumor status (diameter, SBR grading, negative hormone receptor status) [28]. It is now acknowledged that when SSM plus IBR is the primary treatment, it does not delay the start of CT [29][30][31]. On the other hand, randomized studies have demonstrated the usefulness of postmastectomy radiotherapy (PMRT) to decrease local recurrence and increase survival for patients with positive axillary lymph nodes [32,33].…”

Section: Introductionmentioning

confidence: 99%

New concept for immediate breast reconstruction for invasive cancers: feasibility, oncological safety and esthetic outcome of post-neoadjuvant therapy immediate breast reconstruction versus delayed breast reconstruction: a prospective pilot study

Giacalone

Rathat

Daurès

et al. 2010

Breast Cancer Res Treat

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Feasibility and oncological safety of postadjuvant skin-sparing mastectomy (SSM) plus immediate breast reconstruction (IBR) cannot be evaluated by randomized trials. However, comparative study could modify guidelines for the oncosurgical treatment of invasive breast cancer. Our study compared the feasibility, oncological safety and esthetic outcome of SSM plus latissimus dorsi (LD) flap IBR after chemotherapy (CT) and radiotherapy (RT) with the standard management for invasive breast cancer: mastectomy as primary treatment, adjuvant CT and RT, and LD flap delayed breast reconstruction (DBR). Twenty-six selected patients with stages IIA-IIIA breast cancer were offered post-neoadjuvant SSM plus IBR with LD flap plus implant (IBR group). Seventy-eight other patients had primary mastectomy, adjuvant CT and RT, and LD-assisted DBR (DBR group). After 4.1 years (range 1-8) of follow-up, feasibility, oncological safety, and esthetic outcome were compared. Sixteen (61%) early complications were reported for the IBR group versus 44 (56%) for the DBR group (P = 0.645). Early implant loss was 0% in IBR versus 12% in DBR. IBR had 8 (30%) late complications versus 17 (21%) for DBR (P = 0.362). Capsular contracture and reconstruction failure rates were similar. Local recurrence was 7.7% (2/26) in IBR and 6.4% (5/78) in DBR (P = 0.823). Cosmetic evaluation by independent physicians and by the patients themselves was identical in the two groups. Our concept provides a basis for offering more women the opportunity to elect for immediate reconstruction, even in the setting of radiation therapy.

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Section: Introductionmentioning

confidence: 99%

New concept for immediate breast reconstruction for invasive cancers: feasibility, oncological safety and esthetic outcome of post-neoadjuvant therapy immediate breast reconstruction versus delayed breast reconstruction: a prospective pilot study

Giacalone

Rathat

Daurès

et al. 2010

Breast Cancer Res Treat

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“…Research has confirmed the safety and efficacy of both neoadjuvant chemotherapy alone [7][8][9][10] and immediate reconstruction alone [1][2][3]12,[14][15][16][17][18] , but data addressing both concurrently are limited. In 1 study of 22 patients with locally advanced (stage IIB or III) cancer who received neoadjuvant chemotherapy and underwent immediate reconstruction, there was no delay in adjuvant treatment, but the perioperative morbidity rate was 14%.…”

Section: Discussionmentioning

confidence: 99%

Impact of neoadjuvant chemotherapy on breast reconstruction.

Hu¹,

Weeks²,

Chi³

et al. 2010

JCO

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“…7 Wilson et al compared patients undergoing immediate reconstruction following breast conservation therapy or mastectomy, and found no difference between the two groups with respect to initiation of chemotherapy. 20 Taylor and Kumar found a delay of approximately five days after TRAM flap due to issues with the wound. 21 Mortenson et al found an increase in wound complications in patients who underwent immediate reconstruction compared with those who did not.…”

Section: Adjuvant Therapymentioning

confidence: 99%

Breast reconstruction: current and future options

Paul

Prendergast

Nicholson

et al. 2011

BCTT

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Abstract:When initiated by the devastating diagnosis of cancer, post ablative breast restoration has at its core the goal of restoring anatomic normalcy. The concepts of body image, wholeness, and overall well-being have been introduced to explain the paramount psychological influence the breast has on both individuals and society as a whole. Hence, a growing subspecialty has been established to recreate or simulate the lost breast. At least one third of breast cancer victims consider breast reconstruction. Breast reconstruction post mastectomy may be offered at the time of mastectomy or delayed post mastectomy after adjuvant therapy. This may be utilizing autologous tissues or implants and each has risks and benefits, especially when considering adjuvant therapy. In addition, there has been a move away from a traditional mastectomy to less invasive, but still curative procedures, such as skin-sparing and nipple-sparing mastectomy. These procedures provide the breast envelope to facilitate reconstruction. This paper reviews the primary issues in breast reconstruction, as well as their psychologic, oncologic, and social impact. Keywords: breast restoration, body image, breast reconstruction, mastectomy History of breast reconstructionBreast cancer is the second leading cause of cancer-related death among females in the US, and affects one in eight women in their lifetime.1,2 Advances in medical research have dramatically improved the treatment of this disease over the last 50 years. In addition to chemotherapy and radiation therapy, partial and complete mastectomy of diseased and contralateral breasts has become more frequent. However, these surgical modalities often leave patients with anatomical deformities and altered body image, along with the psychologic impact. 3,4 Breast reconstruction is a dynamic and multidisciplinary approach that has grown into a solution for many breast cancer patients treated with surgery. Breast reconstruction began as a means to reduce chest wall complications and deformities from mastectomy, with the goal to recreate symmetry and contour while avoiding delay in adjuvant cancer treatment.1 Breast reconstruction was introduced over a century ago as a surgical modality for rebuilding the anatomic breast using autologous tissues and prosthetic implants. 2,5

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Immediate breast reconstruction does not lead to a delay in the delivery of adjuvant chemotherapy

Cited by 64 publications

References 13 publications

New concept for immediate breast reconstruction for invasive cancers: feasibility, oncological safety and esthetic outcome of post-neoadjuvant therapy immediate breast reconstruction versus delayed breast reconstruction: a prospective pilot study

New concept for immediate breast reconstruction for invasive cancers: feasibility, oncological safety and esthetic outcome of post-neoadjuvant therapy immediate breast reconstruction versus delayed breast reconstruction: a prospective pilot study

Impact of neoadjuvant chemotherapy on breast reconstruction.

Breast reconstruction: current and future options

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