Prognosis of isolated locoregional recurrence after early breast cancer with immediate breast reconstruction surgery: a retrospective multi‑institutional study.

Autor: Seki H; Department of Breast Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-city, Tokyo, 181-8611, Japan. hirohito.seki@gmail.com.; Department of Breast Surgery, Saitama Medical Center, Saitama, Japan. hirohito.seki@gmail.com., Ogiya A; Department of Breast Surgery, Japanese Red Cross Medical Center, Tokyo, Japan.; Department of Breast Surgical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan., 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., Narui K; Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan., Sasada S; Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan., Ishitobi M; Department of Breast Surgery, Mie University School of Medicine, Mie, Japan.; Department of Breast Surgery, Osaka Habikino Medical Center, Osaka, Japan., Nogi H; Department of Breast and Endocrine Surgery, Jikei University School of Medicine, Tokyo, Japan., Kondo N; Department of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan., Sakurai T; Sakurai Breast Clinic, Wakayama, Japan., Yamauchi C; Department of Radiation Oncology, Shiga General Hospital, Shiga, Japan., Mori H; Department of Plastic and Reconstructive Surgery, Tokyo Medical and Dental University, Tokyo, Japan., Saiga M; Department of Plastic Surgery, Okayama University Hospital, Okayama, Japan., Niikura N; Department of Breast Oncology, Tokai University School of Medicine, Kanagawa, Japan., Shien T; Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan.
Jazyk: angličtina
Zdroj: Breast cancer (Tokyo, Japan) [Breast Cancer] 2024 Sep; Vol. 31 (5), pp. 935-944. Date of Electronic Publication: 2024 Jun 19.
DOI: 10.1007/s12282-024-01607-0
Abstrakt: Background: The prognosis in patients with breast cancer with isolated locoregional recurrence (ILRR) without simultaneous distant metastases after immediate breast reconstruction (IBR) remains unknown. We aimed to investigate the prognosis in this patient population.
Methods: This multi-institutional retrospective observational study evaluated 3295 patients with primary breast cancer who underwent IBR at 12 Japanese medical facilities between January 1, 2008 and December 31, 2016. The outcome measures were the prognostic factors for ILRR after IBR, 5-year distant metastasis-free interval (DMFI), and 5-year overall survival (OS).
Results: Mastectomy or skin-sparing mastectomy was performed in 3295 patients. ILRR occurred in 70 patients, and the median observation period from ILRR diagnosis was 39.3 months. Of the 70 patients, 9 (12.9%) had axillary lymph node recurrence (ALNR) at the time of ILRR diagnosis. The 5-year DMFI and OS rates after ILRR were 92.4% and 91.2%, respectively. Pathological lymph node metastasis at primary surgery (P = 0.041) and ALNR (P = 0.022) at ILRR were significantly associated with DMFI in the univariate analysis. ALNR was the only independent prognostic factor in the multivariate analysis (P = 0.041). Post-mastectomy radiation therapy (PMRT; P = 0.022) and ALNR (P = 0.043) were significantly associated with OS in the univariate analysis, and both PMRT (P = 0.010) and ALNR (P = 0.028) were independent prognostic factors in the multivariate analysis for OS.
Conclusions: Although patients with breast cancer who had ILRR after IBR have favorable prognosis, ALNR may lead to poor prognosis. To the best of our knowledge, this study is the first to report the prognosis of these patients.
(© 2024. The Author(s), under exclusive licence to The Japanese Breast Cancer Society.)
Databáze: MEDLINE
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