Mastectomy with immediate breast reconstruction after neoadjuvant chemotherapy and radiation therapy. A new option for patients with operable invasive breast cancer. Results of a 20 years single institution study
| Autor: | P. Gimbergues, G. Le Bouedec, C. Pomel, J.-L. Achard, Jean-Marc Nabholtz, M.-A. Mouret-Reynier, Emilie Monrigal, P. Chollet, Jacques Dauplat, M. Peyronie |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
medicine.medical_specialty Mammaplasty medicine.medical_treatment Breast Neoplasms Risk Assessment Disease-Free Survival Cohort Studies Breast cancer medicine Humans Neoplasm Invasiveness Mastectomy Aged Neoplasm Staging Retrospective Studies business.industry Carcinoma Ductal Breast Cancer Retrospective cohort study General Medicine Capsular contracture Middle Aged Prognosis medicine.disease Combined Modality Therapy Survival Analysis Neoadjuvant Therapy Surgery Radiation therapy Treatment Outcome Oncology Chemotherapy Adjuvant Female Radiotherapy Adjuvant Implant Neoplasm Recurrence Local business Breast reconstruction Follow-Up Studies |
| Zdroj: | European Journal of Surgical Oncology (EJSO). 37:864-870 |
| ISSN: | 0748-7983 |
| DOI: | 10.1016/j.ejso.2011.07.009 |
| Popis: | Purpose To evaluate the feasability of immediate breast reconstruction (IBR) following mastectomy after neoadjuvant chemotherapy (NACT) and radiation therapy (RT) for operable invasive breast cancer (OIBC), in terms of incidence of local complications, locoregional control and survival. Patients and methods From 1990 to 2008, 210 patients were treated by NACT, RT and mastectomy with IBR for OIBC. One hundred and seven patients underwent a latissimus dorsi flap with implant (LDI), 56 patients a transverse rectus abdominis musculocutaneous (TRAM) flap, 25 an autologous latissimus dorsi flap (ALD) and 22, a retropectoral implant (RI) reconstruction. Results Forty-six (21.9%) early events were recorded: 20 necrosis, 9 surgical site infections and 6 haematomas, requiring further surgery in 23 patients. More necrosis were observed with TRAM flap reconstructions (p = 0.000004), requiring more surgical revision than LD reconstructions. Seromas represented 42% of early complications in LD reconstructions. Fifty-five patients presented with late complications (26.2%) with mainly implant complications (capsular contracture, infection, dislocation, deflation) (23.6%), requiring reintervention in 14 cases. There were more delayed surgical revisions in RI reconstructions (p = 0.0005). The 5 years overall and disease-free survival rates were respectively 86.7% and 75.6%. Sixty-four patients presented at least one recurrence (30.5%) with 5 local, 9 locoregional and 54 distant relapses. Conclusion This therapeutic sequence does not seem to increase the IBR morbidity nor alter disease-free and overall survival. |
| Databáze: | OpenAIRE |
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