F De Lorenzi1, G Corso2, F Botta3, A Invento4, A Marchetti5, P Sala5, G Vottero5, V Bagnardi3, C Leonardi6, P Veronesi2, A Goldhirsch7. 1. Division of Plastic and Reconstructive Surgery, European Institute of Oncology IRCCS, Milan, Italy. Electronic address: francesca.delorenzi@ieo.it. 2. Division of Breast Surgery, European Institute of Oncology, IRCCS, Milan, Italy; Department of Oncology and Hemato-Oncology, University of Milan, Italy. 3. Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy. 4. Division of Breast Surgery, European Institute of Oncology, IRCCS, Milan, Italy. 5. Division of Plastic and Reconstructive Surgery, European Institute of Oncology IRCCS, Milan, Italy. 6. Division of Radiation Oncology, European Institute of Oncology, IRCCS, Milan, Italy. 7. Multimedica, Milan, Italy.
Abstract
BACKGROUND: Ipsilateral breast cancer recurrence (IBTR) occurs in about 7% of patients with primary invasive breast tumor. Salvage mastectomy and breast reconstruction are often discussed and latissimus dorsi (LD) flap is frequently proposed. METHODS: We retrospectively investigated 111 consecutive locally relapsing patients who underwent salvage mastectomy and immediate LD reconstruction. All included patients with IBTR previously underwent conserving surgery for BC, and received a postoperative irradiation. Primary endpoints were disease free survival and overall survival. Secondary endpoints were surgical complications and re-interventions. RESULTS: Invasive ductal cancer was the most frequent histotype (60.4%) of breast cancer reappearance. rpT1, rpT2 and rpT3 were observed respectively in 50.5%, 20,7% and 3,6% of the patients. rpTis occurred in 11,7% of cases. Positive axillary nodes were observed in 9,9% of patients at reappearance. Post-operative complication other than seroma occurred in 17,1% of patients, while seroma at the donor site was observed in 61.3% of cases. At 5-year after surgery overall survival was 92% (95% CI: 85%-96%) and disease free survival was 78% (95% CI: 69%-85%). CONCLUSIONS: Immediate latissimus dorsi flap reconstruction in selected patients with isolated breast tumor recurrence, which occurred after breast irradiation, provides an effective treatment with a satisfactory outcome.
BACKGROUND: Ipsilateral breast cancer recurrence (IBTR) occurs in about 7% of patients with primary invasive breast tumor. Salvage mastectomy and breast reconstruction are often discussed and latissimus dorsi (LD) flap is frequently proposed. METHODS: We retrospectively investigated 111 consecutive locally relapsing patients who underwent salvage mastectomy and immediate LD reconstruction. All included patients with IBTR previously underwent conserving surgery for BC, and received a postoperative irradiation. Primary endpoints were disease free survival and overall survival. Secondary endpoints were surgical complications and re-interventions. RESULTS: Invasive ductal cancer was the most frequent histotype (60.4%) of breast cancer reappearance. rpT1, rpT2 and rpT3 were observed respectively in 50.5%, 20,7% and 3,6% of the patients. rpTis occurred in 11,7% of cases. Positive axillary nodes were observed in 9,9% of patients at reappearance. Post-operative complication other than seroma occurred in 17,1% of patients, while seroma at the donor site was observed in 61.3% of cases. At 5-year after surgery overall survival was 92% (95% CI: 85%-96%) and disease free survival was 78% (95% CI: 69%-85%). CONCLUSIONS: Immediate latissimus dorsi flap reconstruction in selected patients with isolated breast tumor recurrence, which occurred after breast irradiation, provides an effective treatment with a satisfactory outcome.
Authors: Francesca De Lorenzi; Francesco Borelli; Pietro Sala; Pietro Loschi; Paola Naninato; Anna Rita Vento; Elisabetta Maria Cristina Rossi; Paolo Veronesi Journal: Breast Care (Basel) Date: 2020-11-04 Impact factor: 2.268
Authors: Coco J E F Walstra; Robert-Jan Schipper; Yvonne E van Riet; Peter-Paul G van der Toorn; Marjolein L Smidt; Maurice J C Vd Sangen; Adri C Voogd; Grard A P Nieuwenhuijzen Journal: Breast Cancer Res Treat Date: 2021-03-13 Impact factor: 4.872