Impact of radiation therapy for breast cancer with involved surgical margin after immediate breast reconstruction: A multi-institutional observational study.

Autor: Sasada S; Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan. Electronic address: shsasada@hiroshima-u.ac.jp., Nagura N; Department of Breast Surgical Oncology, St. Luke's International Hospital, Tokyo, Japan., Shimo A; Department of Breast and Endocrine Surgery, St. Marianna University School of Medicine, Kanagawa, Japan; Department of Breast and Endocrine Surgery, Kawasaki Municipal Tama Hospital, Kanagawa, Japan., Ogiya A; Department of Breast Surgical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan; Department of Breast Surgery, Japanese Red Cross Medical Center, Tokyo, Japan., Saiga M; Department of Plastic and Reconstructive Surgery, Okayama University Hospital, Okayama, Japan., Seki H; Department of Breast Surgery, Saitama Medical Center, Saitama, Japan; Department of Breast Surgery, Kyorin University School of Medicine, Tokyo, Japan., Mori H; Department of Plastic and Reconstructive Surgery, Tokyo Medical and Dental University, Tokyo, Japan., Kondo N; Department of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan., Ishitobi M; Department of Breast Surgery, Mie University School of Medicine, Mie, Japan., Narui K; Department of Breast and Thyroid Surgery, Medical Center, Yokohama City University, Kanagawa, Japan., Nogi H; Department of Breast and Endocrine Surgery, Jikei University School of Medicine, Tokyo, Japan., Yamauchi C; Department of Radiation Oncology, Shiga General Hospital, Shiga, Japan., Sakurai T; Sakurai Breast Clinic, Wakayama, Japan., Shien T; Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan.
Jazyk: angličtina
Zdroj: European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology [Eur J Surg Oncol] 2024 Jun; Vol. 50 (6), pp. 108360. Date of Electronic Publication: 2024 Apr 22.
DOI: 10.1016/j.ejso.2024.108360
Abstrakt: Introduction: Involved surgical margins are risk factors for local recurrence and re-excision is often difficult, particularly in patients with breast cancer undergoing immediate breast reconstruction (IBR). However, the magnitude of the effect of radiation therapy on preventing local recurrence for breast cancers with involved margins has not been sufficiently assessed.
Materials and Methods: We retrospectively assessed sites of involved surgical margins and local recurrence after mastectomy with IBR in patients with early breast cancer between 2008 and 2016. The effect of postoperative radiation therapy was evaluated in patients with involved margins, adjusted for nuclear grade, lymphatic invasion, surgical procedures, and primary systemic therapy.
Results: A total of 274 (5.8 %) out of 4726 patients who underwent mastectomy with IBR had involved surgical margins: 133, 68, 88, and 26 had involvement of the skin, deep margin, lateral margins, and nipple, respectively (including duplicates). Radiation therapy was administered to 54 patients with involved margins. In patients with involved margins, 7-year cumulative incidences of local recurrence were 1.9 % and 12.6 % with and without radiation therapy, respectively (adjusted hazard ratio, 0.17; 95 % CI, 0.04-0.80). Local recurrence occurred in 28 patients, and the sites were skin, subcutaneous tissue, muscle, and nipple-areola complex in 7, 17, 1, and 3 patients, respectively. Among them, 23 (82.1 %) were associated with involved margin sites.
Conclusions: Radiation therapy meaningfully reduced the incidence of local recurrence in patients with breast cancer with margin involvement after mastectomy with IBR. Most local recurrences occurred at involved margin-related sites.
(© 2024 Elsevier Ltd, BASO ∼ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.)
Databáze: MEDLINE
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