Prognostic effect of radiotherapy in breast cancer patients underwent immediate reconstruction after mastectomy

Abstract

IntroductionIt is still unclear whether radiotherapy affects the long-term survival of breast cancer (BC) patients after immediate breast reconstruction (IBR). This study aims to evaluate the actual prognostic impact of radiotherapy on BC patients undergoing IBR, and to construct survival prediction models to predict the survival benefit of radiotherapy.MethodsData on eligible BC patients were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database. Competing risk models were used to assess breast cause-specific death (BCSD) and non-breast cancer cause-specific death (NBCSD). Kaplan‐Meier curve, Cox risk regression model and forest map were used to evaluate and demonstrate overall survival (OS) and breast cancer-specific survival (BCSS). Survival prediction nomograms were used to predict OS and BCSS probabilities.ResultsA total of 22,218 patients were selected, 24.9% received radiotherapy and 75.1% were without radiotherapy. Competing risk models showed that whether BCSD or NBCSD, the cumulative long-term risk of death in the radiotherapy group was higher than that in the non-radiotherapy group. The Kaplan‐Meier curve showed that patients with different lymph node metastasis had different radiotherapy benefits. Multivariate stratified analysis showed that radiotherapy after autologous reconstruction was associated with poor BCSS in patients with stage N0, and radiotherapy after autologous reconstruction and combined reconstruction improved OS and BCSS in patients with stage N3. The C-indexes of nomogram (between 0.778 and 0.847) and calibration curves showed the good prediction ability of survival prediction model.ConclusionsRadiotherapy can improve OS and BCSS in N3 stage BC patients undergoing immediate autologous reconstruction after mastectomy. The practical nomograms can be used to predict OS and BCSS of patients with or without radiotherapy, which is helpful for individualized treatment.

Comparison of clinicopathologic characteristics and survival outcomes of various subtypes of breast cancer

“…While multiple studies have con rmed the bene cial effects of radiotherapy on overall survival (OS) in breast cancer patients 45 , others have suggested that its bene ts may be limited. For instance, Chua et al found that radiotherapy effectively reduced local-regional recurrences but not distant recurrences 46 .…”

Long-term Survival Outcomes in Patients with Locally Advanced Breast Cancer after Total Mastectomy with or without Breast Reconstruction: A Seer-based Analysis

“…These factors could potentially impact the survival outcomes of black patients after breast reconstruction. Radiation therapy may be associated with adverse events of breast reconstruction surgery, such as: reconstruction failure, capsular contracture, and overall complications [24][25][26] [27][28] [29][30] [31]. A retrospective study conducted on breast cancer patients demonstrated that radiotherapy had a positive impact on OS and BCSS in patients with N3 stage who underwent autologous breast reconstruction.…”

YB-1 Expression Is Associated with Lymph Node Metastasis and Drug Resistance to Adriamycin in Breast Cancer

“…Breast cancer (BC) is one of the most common malignancies in women, with 1.3 million cases diagnosed and 400,000 deaths worldwide each year [ 1 , 2 ]. The etiologies of BC are very complex, and its onset and therapeutic effect are related to a variety of factors, such as estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER-2), BRCA, and hormone levels [ 3 , 4 ].…”