Immediate Breast Reconstruction Following Mastectomy for the Treatment of Advanced Breast Cancer Patients

ABSTRACT

PURPOSE: To elucidate whether there is a delay of adjuvant treatment or detection of recurrences, or an increasing of the recurrence of tumorsin clinically advanced breast cancer patients. METHODS: The study group included 55 patients underwent mastectomy with immediate reconstruction (IBR), and 563 patients who received the mastectomy without reconstruction (non-IBR), and who were stage IIB and IIIA breast cancer patients, at Asan Medical Center between Jun 1993 and December 2000. We retrospectively assessed the comparative outcomes through using follow-up data. RESULTS: Out of 2,057 patients who had undergone the mastectomy on during the period, 175 (8.5%) underwent immediate reconstruction. 55 of them (31.6%) were stage IIB and IIIA patients, a similar portion (29.9%) was seen in the 563 patients of same stages without reconstruction. The mean ages of these groups were 37.1 and 46.9 years, that is, the reconstruction group was about 10 years younger. All these patients voluntarily underwent immediate reconstruction. For the patients who were followed up, the local recurrence was 3.6% (2/55) for the IBR group and 5.2% (29/563) for the non-IBR group. On the other hand, the distant relapse rates were 12.7% and 13.9%. The administration of adjuvant chemotherapy was not delayed and radiotherapy was used as an adjuvant treatment after reconstruction in nine of the cases (16.4%). Chemotherapy was also conducted in 98.2% of the IBR group and 77.3% of the non-IBR group. While radiotherapy was used in the IBR group less frequently, there was no statistical difference between the two groups (P=0.63). CONCLUSION: Immediate reconstruction following mastectomy for the treatment of breast cancer is now more frequently performed. IBR can be done in clinically advanced breast cancer without increasing the risk of treatment failure or modification.