Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada.
Ann Surg Oncol. 2022 Dec;29(13):8072-8082. doi: 10.1245/s10434-022-12408-0. Epub 2022 Sep 8.
Breast reconstruction is generally discouraged in women with inflammatory breast cancer (IBC). Nevertheless, reconstruction rates are increasing in this population.
We aimed to determine contemporary trends and predictors of breast reconstruction use and its impact on mortality among IBC patients.
Demographic, clinicopathologic, and follow-up data for women with non-metastatic IBC having mastectomy between 2004 and 2015 were collected from the Surveillance, Epidemiology, and End Results (SEER) 18 registries database. Rates and predictors of immediate breast reconstruction, along with survival outcomes between the breast reconstruction and no reconstruction groups were calculated. To account for selection bias, a propensity score analysis matching one reconstruction patient to three no reconstruction patients was performed.
A total of 4076 women with non-metastatic IBC who underwent mastectomy (388 [9.5%] with breast reconstruction and 3688 [90.5%] without) were included. The proportion of women undergoing breast reconstruction and contralateral prophylactic mastectomy increased from 6.2 to 15.3% and 12.9 to 29.6%, respectively, between 2004 and 2015. Younger age, higher annual income, metropolitan residence, and bilateral mastectomy predicted breast reconstruction use. The 10-year breast cancer-specific survival was 62.9% for women having breast reconstruction and 47.6% for women not having breast reconstruction. After propensity-matched analysis, 10-year cancer-specific survival was similar between the reconstruction (56.6%) and no reconstruction (62.2%) groups (adjusted hazard ratio 0.96, 95% confidence interval 0.79-1.16; p = 0.65).
Breast reconstruction rates continue to rise among IBC patients, particularly young women and women with access to reconstruction. Breast reconstruction is not associated with inferior breast cancer-specific survival and can be an option for select patients.
在患有炎性乳腺癌（IBC）的女性中，一般不鼓励进行乳房重建。然而，在这一人群中，乳房重建的比例正在增加。
我们旨在确定 IBC 患者中使用乳房重建的当代趋势和预测因素及其对死亡率的影响。
从监测、流行病学和最终结果（SEER）18 个登记处数据库中收集了 2004 年至 2015 年间接受乳房切除术的非转移性 IBC 女性的人口统计学、临床病理学和随访数据。计算了即刻乳房重建的发生率和预测因素，以及乳房重建组和无重建组之间的生存结果。为了考虑选择偏差，对一位重建患者与三位无重建患者进行了倾向评分分析匹配。
共纳入 4076 名接受乳房切除术的非转移性 IBC 女性（388 名[9.5%]接受乳房重建，3688 名[90.5%]未接受）。2004 年至 2015 年间，接受乳房重建和对侧预防性乳房切除术的女性比例分别从 6.2%增加到 15.3%和从 12.9%增加到 29.6%。年龄较小、年收入较高、居住在大都市地区和双侧乳房切除术预测了乳房重建的使用。接受乳房重建的女性 10 年乳腺癌特异性生存率为 62.9%，未接受乳房重建的女性为 47.6%。在进行倾向评分匹配分析后，重建组（56.6%）和无重建组（62.2%）的 10 年癌症特异性生存率相似（调整后的危险比为 0.96，95%置信区间为 0.79-1.16；p=0.65）。
在 IBC 患者中，乳房重建的比例继续上升，尤其是年轻女性和有能力接受重建的女性。乳房重建与较差的乳腺癌特异性生存率无关，可为部分患者提供选择。
