Skin-sparing mastectomy and immediate breast reconstruction: incidence of recurrence in patients with invasive breast cancer

Fersis, N.; Hoenig, A.; Relakis, K.; Pinis, Stamatis I.; Wallwiener, D.

doi:10.1016/j.breast.2004.06.009

Cited by 49 publications

(30 citation statements)

References 22 publications

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“…The performance of reconstruction did not have a negative effect on the recurrence and survival [4,5] . By followed up to 66 months, the locoregional relapse rate was 4.1%, similar to most reported 3%~8% [13][14][15] . The DFS and RFS survival of the two modalities had no differences, although the median follow-up time is only 9 months.…”

Section: Discussionsupporting

confidence: 83%

Immediate breast reconstruction with latissimus dorsi musculocutaneous flap: A suitable option for chinese women after mastectomy

et al. 2006

Chin. J. Cancer Res.

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Objective:To discuss the suitable immediate breast reconstruction modalities for Chinese patients by comparing the pedicled transverse rectus abdominis myocytaneous flap (TRAM) reconstruction with latissimus dorsi myocytaneous flap (LTD) reconstruction plus implants or not after mastectomy due to breast cancer. Methods: From Jan. 2000 to Jul. 2005, 74 staged 0-II patients (mean age 39) were performed immediate breast reconstruction with autologous tissue either using LTD flaps or pedicled TRAM flaps with supplemental implants when necessary after mastectomy due to breast cancer and the charts were reviewed. Results: The age, marriage and menses status did not affect the selection of modalities and the need of implants. In 74 patients, 62 cases (83.8%) were performed LTD reconstruction with 13 implants and 12 cases received TRAM with 1 implant. The difference in need of implants or not between the two modalities had no statistical significance (P=0.442, Fisher' exact test). Aesthetic results judged as good or fair were in 88% patients and the cosmetic effects between LTD and TRAM groups or implant and non-implant groups had no differences. All reconstructions were successful, with 4.1% cumulative locoregional recurrence and 100% overall survival by following up to 66 months (median 9 months). The DFS and RFS between the two modalities had no significant differences by log rank test. Conclusion: Immediate autologous tissue reconstruction makes it possible to regain the natural and symmetric contour of breast without increased local recurrence. The LTD flap reconstruction is a suitable option for most Chinese women as well as the pedicled TRAM flap.

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Section: Discussionsupporting

confidence: 83%

Immediate breast reconstruction with latissimus dorsi musculocutaneous flap: A suitable option for chinese women after mastectomy

et al. 2006

Chin. J. Cancer Res.

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“…We conclude that our surgical procedure is a safe option, and after these preliminary results we found no difference in comparison with standard approaches using delayed breast reconstruction. However, our study findings would be strengthened by a longer followup, as LR rates and cancer-related death are known to increase over time [20,55,59,60].…”

Section: Discussionmentioning

confidence: 84%

“…In recent years, skin-sparing mastectomy (SSM) in combination with IBR has gained in acceptance and popularity for early invasive or in situ disease (DCIS) in terms of both oncological safety and acceptable rates of postoperative complications [7][8][9][10][11][12][13][14][15]. More recent reports have also documented the effectiveness of SSM plus IBR for locally advanced disease [16][17][18][19][20][21][22][23][24]. These studies showed complication rates comparable to those of a similar group of patients who did not undergo IBR.…”

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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“…[5][6][7] In the majority of instances (70-75%), LR occurs within three years of an SSM. 9 The rate of LR in our series was no greater than that expected after a conventional mastectomy.…”

Section: Discussionmentioning

confidence: 58%

A single institution experience with skin sparing mastectomy and immediate breast reconstruction

Doddi

Singhal

Kasem

et al. 2011

annals

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According to the NHS Information Centre's Hospital Episode Statistics, 131,566 women in England were diagnosed with breast cancer in [2004][2005]. Of these, 16,838 underwent a mastectomy, of which only 1,623 (9.6%) benefited from a skin sparing approach. It is expected that almost all women who have been recommended a mastectomy will be offered reconstruction in the immediate setting or as a delayed procedure. Skin sparing mastectomies (SSMs) and immediate breast reconstruction (IBR) preserves the natural contours by sparing the native skin, preserves sensation, minimises scars, gives cosmetic results (thereby increasing self esteem) and lowers psychological morbidity.1 Oncological safety in terms of local and systemic recurrence is a serious concern. MethodsA retrospective study was carried out on all patients with breast cancer treated with an SSM and IBR over a six-year period from 1999 to 2005. A single consultant breast surgeon carried out all SSMs and IBRs in a single institution. All patients were discussed in our local multidisciplinary meeting before and after surgery. ResultsA total of 108 patients, with a mean age of 49 years (range: 28-70 years), underwent an SSM and IBR, of which 78 patients (72.22%) had invasive cancer and 30 (27.78%) had a ductal carcinoma in situ (DCIS) only. Of the invasive cancers, 63 were ductal, 9 were lobular and 6 had other histological types. The mean tumour size of the invasive cancers on final histology was 29.9mm and ranged from 2mm to 100mm. Tumour grade (modified Scarff-Bloom-Richardson grading system), 2,3 lymph node involvement, lymphovascular invasion and receptor status are given in Table 1, Nottingham prognostic index in Table 2 and TNM (tumour, nodes, metastasis) staging 4 in Table 3. In our series of 108 patients, 67 patients had a primary mastectomy, 27 had a completion mastectomy and 8 patients underwent an SSM for recurrence after breast conserving surgery. Four patients had a bilateral SSM for bilateral disease. Three patients opted for a contralateral prophylactic mastectomy.Seventy-five patients (69.44%) had a latissimus dorsi flap with or without an implant and five patients (4.62%) underwent reconstruction utilising a pedicled transverse rectus abdominis myocutaneous flap. The other 28 patients (25.93%) had implant-based reconstruction only.Of the 25 patients who had post-reconstruction radiotherapy, 9 developed a capsular contracture and 8 of these required an exchange of implant. Thirty-three patients (30.56%) had chemotherapy, of whom 20 required adjuvant radiotherapy as well. Two patients in our series had neoadjuvant chemotherapy prior to their SSM and IBR. In two patients there was a delay of two months in commencement

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Skin-sparing mastectomy and immediate breast reconstruction: incidence of recurrence in patients with invasive breast cancer

Cited by 49 publications

References 22 publications

Immediate breast reconstruction with latissimus dorsi musculocutaneous flap: A suitable option for chinese women after mastectomy

Immediate breast reconstruction with latissimus dorsi musculocutaneous flap: A suitable option for chinese women 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

A single institution experience with skin sparing mastectomy and immediate breast reconstruction

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