Local Recurrence Risk after Skin-Sparing and Conventional Mastectomy: A 6-Year Follow-Up

Abstract

In this study, the records of all patients at the University of Texas M. D. Anderson Cancer Center with T1 or T2 breast cancer who were treated between March of 1986 and November of 1990 with mastectomy followed by immediate breast reconstruction were reviewed for the presence of recurrent disease. Patients with in situ disease were not included. Patients were included in the study if a local recurrence occurred (regardless of the length of follow-up) or if a follow-up of 6 years or longer could be obtained. Patients were grouped according to the use or nonuse of skin-sparing mastectomy, by tumor stage, and by nuclear grade of the tumor. The series included 154 patients, of whom 114 had skin-sparing mastectomies and 40 had nonskin-sparing mastectomies. The local recurrence rate in the skin-sparing mastectomy group was 7.0 percent, whereas in the nonskin-sparing mastectomy group it was 7.5 percent. The sample size in the nonskin-sparing mastectomy group was too small for meaningful statistical analysis, but the data suggest that there is no clinically important difference in recurrence rates between the two groups. We conclude that the use of skin-sparing technique for early breast cancer patients does not significantly increase the risk of tumor recurrence after mastectomy.

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

“…However, these results should be confirmed by direct comparison in much larger series. The LR and cancer-related death rates were not significantly different in the two groups and compared favorably with the findings of other published series of patients who underwent SSM and patients with locally advanced disease who were treated by mastectomy with or without reconstruction [5,54,55]. The recurrence rates reported in the literature increased with stage, from 3% for stage I to 11.1% for stage III, from 3.7% for T1 to 9.9% for T2-T4, and from 0% for stage I to 25% for stage III [9,11,13].…”

“…Kroll concluded from the IBR series from M.D. Anderson that SSM did not increase the risk of LR [54]. Sandelin found an 8% LR rate in a series of 100 IBRs with a mean follow-up of 36 months [58].…”

Immediate reconstruction with implants in women with invasive breast cancer does not affect oncological safety in a matched cohort study

“…The timing and type of reconstructions can vary with local traditions but the demand for reconstruction is growing. Traditionally, women with ductal carcinoma in situ and T1-2 tumors are offered immediate breast reconstruction (IBR), while those presumed to receive radiotherapy or those with more advanced breast cancer usually are recommended to have delayed procedures [9][10][11]. The latter patients are often advised to wait for 1-2 years after adjuvant treatment before starting the reconstruction.…”

Invasive Breast Cancer after Mastectomy and Autologous Breast Reconstruction

“…In a study by Kroll et al [4] local recurrence (LR) rates were lower in patients with T1 tumors compared to T2 tumors (6% versus 9%), but this difference was not statistically significant. A trend was also identified for a high nuclear grade being associated with a higher risk of LR.…”

“…The overall incidence of locoregional recurrence after mastectomy ranges from 2-15% at five years [4][5][6]. Tissue transfer procedures are an oncologically safe option for breast reconstruction [7,8].…”