From the Department of Plastic Surgery, CHU UCL Namur, Namur, Belgium.
Ann Plast Surg. 2021 Dec 1;87(6):623-627. doi: 10.1097/SAP.0000000000002869.
The purpose of this study was to assess the oncologic safety of mastectomies associated with immediate breast reconstruction (IBR) in terms of recurrence and survival.
A retrospective review was conducted at a single center (CHU UCL Namur, Belgium). We analyzed the oncologic safety of IBR for patients with invasive and in situ breast cancer who underwent mastectomy associated with IBR. Patients who underwent palliative surgery and those with a diagnosis of breast sarcoma were excluded.
We retrospectively analyzed 138 patients who underwent mastectomy and IBR between January 2012 and December 2019. Most reconstruction procedures used deep inferior epigastric perforator free flaps (55.1%). The reconstructive failure rate was 8.7%. Among the patients included, 5 cases of local cancer recurrence, 1 case of local cancer recurrence associated with distant metastasis, and 2 cases of systemic recurrence were identified during a mean follow-up of 49.3 months (range, 8-104 months) after surgery. Overall survival was 97.8%, and disease-free survival was 94.2%.
Patients had a low incidence of cancer recurrence in this review. Immediate breast reconstruction after mastectomy had no negative impact on recurrence or patient survival, even in patients with advanced disease. The study findings suggest that mastectomy associated with IBR can be a safe surgical option for patients with invasive and noninvasive breast cancers. Longer follow-ups are needed to confirm these preliminary results.
本研究旨在评估即刻乳房重建(IBR)相关乳房切除术的肿瘤安全性,包括复发和生存情况。
在单中心(比利时 CHU UCL Namur)进行回顾性研究。我们分析了因浸润性和原位乳腺癌行乳房切除术并同期接受 IBR 的患者的 IBR 肿瘤安全性。排除姑息性手术和乳腺肉瘤诊断的患者。
我们回顾性分析了 2012 年 1 月至 2019 年 12 月期间接受乳房切除术和 IBR 的 138 例患者。大多数重建手术采用腹壁下动脉穿支游离皮瓣(55.1%)。重建失败率为 8.7%。在纳入的患者中,术后平均随访 49.3 个月(8-104 个月)期间,有 5 例局部癌症复发,1 例局部癌症复发伴远处转移,2 例全身复发。总生存率为 97.8%,无病生存率为 94.2%。
在本研究中,患者的癌症复发率较低。乳房切除术后即刻乳房重建对复发或患者生存无负面影响,即使是在晚期疾病患者中也是如此。研究结果表明,对于浸润性和非浸润性乳腺癌患者,乳房切除术联合 IBR 可以是一种安全的手术选择。需要更长时间的随访来确认这些初步结果。