Timing between Breast Reconstruction and Oncologic Mastectomy—One Center Experience

Abstract

Background and objectives: Breast cancer is the most common cancer in women. The immunohistochemical profile, but also the stage of the tumor determines the therapeutic management, which varies from conservative surgery to mastectomy associated with chemotherapy, hormonal and biological therapy and/or radiotherapy. Mastectomy remains one of the most radical surgical intervention for women, having great consequences on quality of life, which can be improved by realizing immediate or delayed breast reconstruction. The objective of the study was to evaluate the period of time between the mastectomy and the breast reconstruction. Material and methods: We performed a retrospective study on 57 female patients admitted to the Plastic Surgery Department of the Clinical Emergency Hospital “Prof. Dr. Agrippa Ionescu”, Bucharest, Romania. All the patients underwent immediate or delayed breast reconstruction after mastectomy for confirmed breast cancer. Descriptive data analysis was realized with evaluation of type of breast reconstruction considering the staging of the tumor, the invaded lymph nodes, and the necessity of adjuvant chemoradiotherapy. Moreover, the median period between mastectomy and reconstruction was evaluated. Results: The immediate breast reconstruction was performed in patients with stage I, in patients with stage II, delayed reconstruction was performed after minimum six months, and the patients with stage III had the breast reconstructed with free flap (50%), 8–43 months post-mastectomy. Radiotherapy determines the type of breast reconstruction, in most of the cases the latissimus dorsi flap was used with implant (22.6%). Conclusions: Breast reconstruction is an important step in increasing the quality of life for women who underwent mastectomy after breast cancer. The proper timing for breast reconstruction must be settled by a team formed by the patient, the plastic surgeon, and the oncologist.

Histological Aspects and Quantitative Assessment of Ki67 as Prognostic Factors in Breast Cancer Patients: Result from a Single-Center, Cross Sectional Study

“…Ki67 is an important molecular factor that can predict both overall survival (OS) and progression-free survival (PFS). This predictive marker, correlated with others like clinical study, hormonal receptors or histological tumor grade, is generally associated with prognostic significance in breast cancer patients [ 6 ].…”

“…This classification shifted clinical management of breast cancer from being based on tumor burden to biology-centered approaches. Currently, a clinical practice typically uses a surrogate classification of five subtypes based on histological and molecular characteristics, taking into account the expression of Ki67 [ 4 , 5 , 6 , 7 , 8 ]. Prognostic factors are used for the estimation of how aggressive the tumor may evolve and for the decision of treatment approach.…”

Level of education, background and clinical stage as prognostic factors according RMST function in patients with early and locally advanced breast cancer: a single institution experience from Romania

“…Instead, risk factors help identify women who may benefit most from screening or other preventive measures. Women should work with their clinicians to determine their own personal risk of breast cancer based upon their own circumstances [5][6][7][8].…”