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使用大纹理和微纹理假体进行乳房植入重建时的乳腺癌局部复发风险:一项多中心回顾性队列研究

Breast Cancer Local Recurrence Risk in Implant-Based Breast Reconstruction with Macrotexturized and Microtexturized Prosthesis: A Multicentric Retrospective Cohort Study.

作者信息

Vinci Valeriano, Klinger Francesco, Di Giuli Riccardo, Lisa Andrea Vittorio Emanuele, Catania Barbara, Vaccari Stefano, Caimi Edoardo, Pitassi Emanuele, Filippo Jacopo Di, Gentile Damiano, Tinterri Corrado, Janszen Gerardus Johannes, Klinger Marco

机构信息

Department of Biomedical Sciences, Humanitas University, Milan, Italy.

Department of Plastic and Reconstructive Surgery, Humanitas Clinical and Research Center-IRCCS, Milan, Italy.

出版信息

Indian J Plast Surg. 2024 May 30;57(5):372-378. doi: 10.1055/s-0044-1787059. eCollection 2024 Oct.

Abstract

Nowadays, implant-based breast reconstruction is a common technique after mastectomy. The widespread use of implant employment is prompting significant concerns regarding the oncological safety of prostheses and the potential impact of surface texture on the recurrence of local breast cancer. This article examines the oncological outcomes associated with postmastectomy breast reconstructions using micro- and macrotexturized implants, focusing on the incidence and relative risk (RR).  A retrospective cohort study was conducted on patients admitted to Multimedica group (IRCCS, San Giovanni Hospital, Milan) and ICH groups (Humanitas Clinical Institute, Milan) between January 2003 and September 2020. Minimum follow-up considered was of 1 year. Patients submitted to either complete or nipple-spearing mastectomy, who underwent breast reconstruction with macrotexturized or microtexturized prosthesis, were included in group A and B, respectively.  A total of 646 patients met the basic inclusion and exclusion criteria. Group A included 410 (63.5%) patients and group B included 236 (36.5%). Cancer recurrence absolute risk in group A was 5.6 ± 2.2% and in group B was of 2.1 ± 1.8%. RR for breast cancer recurrence in group A compared to group B was of 2.65; confidence interval 95% (1.02; 6.87). Statistical analysis identified a higher local recurrence risk in patients reconstructed with macrotexturized prosthesis ( -value 0.036).  This study detected a higher risk for local breast cancer recurrence associated to macrotexturized breast implants employment. Further investigations are required to verify these outcomes.

摘要

如今,乳房切除术后基于植入物的乳房重建是一种常见技术。植入物的广泛使用引发了人们对假体肿瘤学安全性以及表面纹理对局部乳腺癌复发潜在影响的重大关注。本文研究了使用微观和宏观纹理化植入物进行乳房切除术后乳房重建的肿瘤学结果,重点关注发病率和相对风险(RR)。

对2003年1月至2020年9月期间入住Multimedica组(IRCCS,米兰圣乔瓦尼医院)和ICH组(米兰Humanitas临床研究所)的患者进行了一项回顾性队列研究。最短随访时间为1年。分别接受完全乳房切除术或乳头保留乳房切除术并使用宏观纹理化或微观纹理化假体进行乳房重建的患者被纳入A组和B组。

共有646名患者符合基本纳入和排除标准。A组包括410名(63.5%)患者,B组包括236名(36.5%)患者。A组癌症复发的绝对风险为5.6±2.2%,B组为2.1±1.8%。A组与B组相比,乳腺癌复发的RR为2.65;95%置信区间(1.02;6.87)。统计分析发现,使用宏观纹理化假体进行重建的患者局部复发风险更高(P值0.036)。

本研究发现,使用宏观纹理化乳房植入物与局部乳腺癌复发风险较高相关。需要进一步研究来验证这些结果。

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本文引用的文献

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Plast Reconstr Surg Glob Open. 2022 Mar 24;10(3):e4215. doi: 10.1097/GOX.0000000000004215. eCollection 2022 Mar.
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Breast cancer recurrence: factors impacting occurrence and survival.乳腺癌复发:影响发生及生存的因素
Ir J Med Sci. 2022 Dec;191(6):2501-2510. doi: 10.1007/s11845-022-02926-x. Epub 2022 Jan 25.

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