Factors influencing the decision to offer immediate breast reconstruction after mastectomy for ductal carcinoma in situ (DCIS): the Institut Gustave Roussy Breast Cancer Study Group experience
Autor: | Alexandre Leduey, Iptissem Naoura, Frédéric Kolb, Suzette Delaloge, Jean-Rémi Garbay, Françoise Rimareix, Guillaume Karsenti, Chafika Mazouni, Joseph Ghanimeh, Nicolas Leymarie, Benjamin Sarfati |
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Rok vydání: | 2012 |
Předmět: |
Counseling
medicine.medical_specialty Time Factors medicine.medical_treatment Mammaplasty Sentinel lymph node Decision Making Breast Neoplasms Modified Radical Mastectomy law.invention Diabetes Complications Breast cancer Mastectomy Modified Radical law Ductal carcinoma in situ (DCIS) medicine Humans Obesity Retrospective Studies business.industry Sentinel Lymph Node Biopsy General surgery Communication Age Factors General Medicine Ductal carcinoma Middle Aged medicine.disease Surgery Carcinoma Intraductal Noninfiltrating Breast implant Female business Breast reconstruction Mastectomy |
Zdroj: | Breast (Edinburgh, Scotland). 22(5) |
ISSN: | 1532-3080 |
Popis: | Background The increased rate of ductal carcinoma in situ (DCIS) is associated with a rise in indications for mastectomy and immediate breast reconstruction (IBR). The purpose of our study was to evaluate the factors affecting the indications for IBR and its modalities. Study design Data concerning two hundred and thirty-eight consecutive patients with DCIS who had undergone modified radical mastectomy and a sentinel lymph node biopsy (SLNB) between 2005 and 2011 were extracted from our database. We then conducted a comparative study between patients who had undergone IBR and those who had not, to determine which factors affected the decision to offer IBR (LOE II). Results About 57.1% had IBR and 42.9% had no reconstruction. The most common reason why IBR had not been performed was that it had not been proposed by the surgeon (33.4%). Of the 136 patients offered IBR, an implant had been proposed to the majority of them (81.6%). The IBR rate was highest among women under 50 years (52.2%), and was lower among women with diabetes (0.7%) or obesity (8.8%). The choice of reconstruction was not affected by tobacco use or positive SLNB results. Conclusion Factors predictive of the IBR reflect the influence of surgeon counselling and, to a lesser extent, consideration of patient comorbidities. However, there is a need to improve patient information and physician referral. |
Databáze: | OpenAIRE |
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