Immediate reconstruction after mastectomy became confirmed treatment that brought breast cancer patient better esthetic benefit. Recently many comparatively locally advanced breast cancer patient also became to receive this operation.The purpose of this present study is to investigate prognosis in patients with/without immediate reconstruction.
A retrospective study on 353 patients (stage II-IV) who underwent mastectomy and had pre/post operative chemotherapy in our institute between 2007 and 2014 was conducted. 39 patients (11% of all) had immediate reconstruction (IR), and 314 patients had mastectomy only (M). Clinicopathological predictive factors, operation procedure, and prognosis (local recurrence or distant metastasis) were collected by chart review.
Patient stage in each group (IR/M) was stage II (23/181 case), III (11/73 case), IV (5/60 case). Median tumor size was 3.6/3.9 cm.(range 2.1-14/2.1-12 cm) As to reconstruction, operation procedure was 6 of implant, 11 of latissimus dorsi muscular flap (LD), and 22 rectus abdominis myocutaneous or deep inferior epigastric perforator flap. Local recurrence occurred 5 cases (9.6%) in IR, 20 cases (6.4%) in M, respectively. Median DFI was 12/42 months. 13 cases (25%) in IR developed distant metastasis, 12 cases (3.8%) in M. Univariate analyses on prognosis by the Kaplan and Meier method shows significant differences between IR and M in regard to both local recurrence and distant metastasis. Among clinical characteristics and operation procedure investigated, presence of high Ki-67, triple negative, and advanced stage was significantly associated with poorer prognosis while other factors including age, tumor size, reconstruction procedure were not significant.
Immediate reconstruction was found to be significantly associated with higher recurrence and distant metastasis rate. Furthermore, high Ki-67, triple negative, and advanced stage are more important notice in the treatment of locally advanced breast cancer.
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All authors have declared no conflicts of interest.