Adachi Yayoi, Okumura Seiko, Sawaki Masataka, Hattori Masaya, Yoshimura Akiyo, Gondo Noami, Kotani Haruru, Iwase Madoka, Kataoka Ayumi, Sugino Kayoko, Horisawa Nanae, Ozaki Yuri, Endo Yuka, Sakamoto Shoko, Iwata Hiroji
Department of Breast Oncology, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa, Nagoya, 464-8681, Japan.
Department of Plastic Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa, Nagoya, 464-8681, Japan.
Breast Cancer. 2020 Jul;27(4):716-723. doi: 10.1007/s12282-020-01065-4. Epub 2020 Mar 11.
Immediate breast reconstruction (IBR) has been become a standard treatment for patients with breast cancer undergoing mastectomy. However, whether IBR is appropriate in patients undergoing neoadjuvant chemotherapy (NAC) is still unclear. Therefore, in this study we examined the rates of operative adverse events (AEs), risk factors for operative AEs, and effects on chemotherapy and radiotherapy of IBR with NAC.
Between January 2012 and March 2018, 593 patients underwent IBR at the Aichi Cancer Center Hospital. We retrospectively obtained clinical data of all these patients from their medical records and identified 56 patients (65 breasts) who had received NAC (NAC group) and 537 patients (568 breasts) who had not (non-NAC group). We compared the rates of operative AEs, risk factors for operative AEs, chemotherapy-related AEs, and duration to radiotherapy between the NAC and non-NAC cohorts.
The rate of operative AEs was significantly higher in the NAC than the non-NAC group (35% vs. 22%, p < 0.05). However, axillary lymph node dissection was the most influential risk factor, and NAC was not identified as a risk factor for operative AEs in patients who had undergone IBR. Additionally, there were no statistically significant differences in chemotherapy-related AEs or interval between surgery and postoperative radiotherapy between the NAC and non-NAC groups.
NAC remains likely to contribute to increased postoperative AEs in patients undergoing IBR; however, it does not affect postoperative treatment and IBR is appropriate for patients undergoing NAC.
即刻乳房重建（IBR）已成为接受乳房切除术的乳腺癌患者的标准治疗方法。然而，IBR在接受新辅助化疗（NAC）的患者中是否适用仍不清楚。因此，在本研究中，我们检查了手术不良事件（AE）的发生率、手术AE的危险因素以及IBR联合NAC对化疗和放疗的影响。
2012年1月至2018年3月期间，593例患者在爱知县癌症中心医院接受了IBR。我们从他们的病历中回顾性获取了所有这些患者的临床数据，并确定了56例接受NAC的患者（65个乳房）（NAC组）和537例未接受NAC的患者（568个乳房）（非NAC组）。我们比较了NAC组和非NAC组之间手术AE的发生率、手术AE的危险因素、化疗相关AE以及放疗持续时间。
NAC组的手术AE发生率显著高于非NAC组（35%对22%，p<0.05）。然而，腋窝淋巴结清扫是最有影响的危险因素，在接受IBR的患者中，NAC未被确定为手术AE的危险因素。此外，NAC组和非NAC组之间在化疗相关AE或手术与术后放疗之间的间隔方面没有统计学上的显著差异。
NAC仍可能导致接受IBR的患者术后AE增加；然而，它不影响术后治疗，IBR适用于接受NAC的患者。
