Sungmin Park1, Joon Jeong2, Wonshik Han3, Young Joo Lee4, Hyun-Ah Kim5, Seokwon Lee6, Kyung Do Byun7, Young Jin Choi1, Jiyoung Kim8, Soo Youn Bae9,10. 1. Department of Breast Surgery, Chungbuk National University Hospital, College of Medicine, Chungbuk National University, Cheongju-si, Republic of Korea. 2. Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea. 3. Department of Breast Surgery, Seoul National University Hospital, College of Medicine, Seoul National University, Seoul, Republic of Korea. 4. Division of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea. 5. Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea. 6. Department of Surgery, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea. 7. Department of Surgery, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Republic of Korea. 8. Department of Breast Surgery, Daerim St. Mary's Hospital, Seoul, Republic of Korea. 9. Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea. baessu@gmail.com. 10. Division of Breast and Endocrine Surgery, Department of Surgery, Korea University Hospital, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 02841, Korea. baessu@gmail.com.
Abstract
PURPOSE: In this study, we compared the prognoses of patients who underwent mastectomy with immediate breast reconstruction (IBR) after neoadjuvant chemotherapy with those who underwent mastectomy. METHODS: This retrospective study included 87,995 patients who were surgically treated for primary breast cancer between 2008 and 2014. We compared the three groups of patients who were divided based on the following surgeries: breast-conserving surgery (BCS), mastectomy, and mastectomy with IBR. RESULTS: Of the 3295 patients who were treated with neoadjuvant chemotherapy, 482 patients achieved a pathological complete response (pCR) and 2813 patients did not (non-pCR). In survival analysis of the pCR patients, the 5-year Overall Survival (5 yr OS) between those who underwent mastectomy with IBR and mastectomy (P = 0.639) In the non-pCR group, 5 yr OS of the mastectomy with IBR group was 90.0%, while those of the mastectomy group was 84.4% in patients with clinical stage II (P = 0.032). In a multivariate analysis by Cox regression method revealed that the prognoses of the patients who underwent mastectomy with IBR were not different from those of patients who underwent mastectomy group in both groups (the pCR group and the non-pCR group). CONCLUSION: In the pCR group, the prognoses of patients who underwent mastectomy with IBR were not different from those of patients who underwent mastectomy. In the non-pCR group, women in the mastectomy with IBR group had shown worse prognoses than the mastectomy group in advanced clinical stage. Appropriate operation should be determined depending on the status of individualized patients.
PURPOSE: In this study, we compared the prognoses of patients who underwent mastectomy with immediate breast reconstruction (IBR) after neoadjuvant chemotherapy with those who underwent mastectomy. METHODS: This retrospective study included 87,995 patients who were surgically treated for primary breast cancer between 2008 and 2014. We compared the three groups of patients who were divided based on the following surgeries: breast-conserving surgery (BCS), mastectomy, and mastectomy with IBR. RESULTS: Of the 3295 patients who were treated with neoadjuvant chemotherapy, 482 patients achieved a pathological complete response (pCR) and 2813 patients did not (non-pCR). In survival analysis of the pCR patients, the 5-year Overall Survival (5 yr OS) between those who underwent mastectomy with IBR and mastectomy (P = 0.639) In the non-pCR group, 5 yr OS of the mastectomy with IBR group was 90.0%, while those of the mastectomy group was 84.4% in patients with clinical stage II (P = 0.032). In a multivariate analysis by Cox regression method revealed that the prognoses of the patients who underwent mastectomy with IBR were not different from those of patients who underwent mastectomy group in both groups (the pCR group and the non-pCR group). CONCLUSION: In the pCR group, the prognoses of patients who underwent mastectomy with IBR were not different from those of patients who underwent mastectomy. In the non-pCR group, women in the mastectomy with IBR group had shown worse prognoses than the mastectomy group in advanced clinical stage. Appropriate operation should be determined depending on the status of individualized patients.
Entities:
Keywords:
Breast cancer; Breast reconstruction; Neoadjuvant chemotherapy; Prognosis
Authors: Emma Hormbrey; Cheng Han; Anthony Roberts; Duncan Angus McGrouther; Adrian L Harris Journal: Clin Cancer Res Date: 2003-10-01 Impact factor: 12.531