一项根据分子亚型对即刻乳房重建术后乳腺癌局部和远处复发情况的单中心回顾性分析。
A Single-Center Retrospective Analysis of Local and Distant Relapse of Breast Cancer Following Immediate Breast Reconstruction According to Molecular Subtypes.
作者信息
Han Chunyong, Zhang Xuehui, Sun Jingyan, Liu Jing, He Shanshan, Yin Jian
机构信息
Department of Breast Reconstruction, The Sino-Russian Joint Research Center for Oncoplastic Breast Surgery, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
National Clinical Research Center for Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
出版信息
Front Oncol. 2022 Jun 2;12:912163. doi: 10.3389/fonc.2022.912163. eCollection 2022.
PURPOSE
Concerns have been raised about the oncologic safety of immediate breast reconstruction (IBR) following mastectomy for breast cancer. This study aimed to evaluate locoregional recurrence (LRR) and distant metastasis (DM) of breast cancer according to its molecular subtype in patients who underwent mastectomy alone or IBR after mastectomy.
METHODS
In this retrospective cohort study, consecutive breast cancer patients treated by the single senior surgeon (XZ) between February 2010 and December 2014 were eligible. In total, 389 consecutive patients were included; 295 patients underwent mastectomy alone and 94 patients underwent mastectomy with IBR. Data were retrospectively collected and analyzed for LRR and DM stratified by molecular subtypes.
RESULTS
With a median follow-up of 73 and 87.5 months, 1.69% of patients in the mastectomy alone group developed LRR compared to 0% in the reconstruction group (p = 0.342) and the total incidence of DMs was 11.52% in patients who received mastectomy alone and 7.44% in patients who received postmastectomy IBR (p = 0.262), respectively. The cumulative incidence of LRR was 2.1% vs. 0% for luminal A, 0% vs. 0% for luminal B, 0% vs. 0% for human epidermal growth factor receptor 2 (HER2)-enriched, and 4.5% vs. 0% for triple-negative in the mastectomy alone group compared to the postmastectomy IBR group. The cumulative incidence of DM was 15.5% vs. 5.7% for luminal A, 10% vs. 8.7% for luminal B, 17.3% vs. 0% for HER2-enriched, and 6.8% vs. 7.1% for triple-negative in the mastectomy alone group compared to the postmastectomy IBR group. On multivariable Cox regression analysis, lymph node metastasis was associated with an increased risk of DM in the mastectomy alone group (p = 0.03) and neoadjuvant chemotherapy was associated with an increased risk of DM in the postmastectomy IBR group (p = 0.021).
CONCLUSION
This study suggests that IBR does not have a negative impact on the LRR and DM of breast cancer according to molecular subtypes.
目的
乳腺癌乳房切除术后即刻乳房重建（IBR）的肿瘤学安全性引发了关注。本研究旨在评估单纯乳房切除术或乳房切除术后IBR患者中，根据分子亚型划分的乳腺癌局部区域复发（LRR）和远处转移（DM）情况。
方法
在这项回顾性队列研究中，纳入了2010年2月至2014年12月期间由同一位资深外科医生（XZ）治疗的连续性乳腺癌患者。总共纳入了389例连续性患者；295例患者接受了单纯乳房切除术，94例患者接受了乳房切除术后IBR。回顾性收集数据并分析按分子亚型分层的LRR和DM情况。
结果
中位随访时间分别为73个月和87.5个月，单纯乳房切除术组1.69%的患者发生LRR，而重建组为0%（p = 0.342）；单纯乳房切除术患者的DM总发生率为11.52%，乳房切除术后IBR患者为7.44%（p = 0.262）。与乳房切除术后IBR组相比，单纯乳房切除术组中腔面A型的LRR累积发生率为2.1% vs. 0%，腔面B型为0% vs. 0%，人表皮生长因子受体2（HER2）富集型为0% vs. 0%，三阴性为4.5% vs. 0%。与乳房切除术后IBR组相比，单纯乳房切除术组中腔面A型的DM累积发生率为15.5% vs. 5.7%，腔面B型为10% vs. 8.7%，HER2富集型为17.3% vs. 0%，三阴性为6.8% vs. 7.1%。多变量Cox回归分析显示，单纯乳房切除术组中淋巴结转移与DM风险增加相关（p = 0.03），乳房切除术后IBR组中新辅助化疗与DM风险增加相关（p = 0.021）。
结论
本研究表明，IBR对根据分子亚型划分的乳腺癌LRR和DM没有负面影响。
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