Lee Jung Soo, Won Hye Sung, Nam Hyung Seok, Kim Yeo Hyung
Department of Rehabilitation Medicine, College of Medicine, The Catholic University of Korea, Seoul, 06591, Republic of Korea.
Division of Oncology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
Sci Rep. 2025 Aug 5;15(1):28584. doi: 10.1038/s41598-025-10430-2.
This study assessed the impact of immediate breast reconstruction on lymphedema incidence in women diagnosed with breast cancer. We included 45,734 women aged ≥ 30 years treated for breast cancer (ICD-10 primary diagnostic code C50) since 2017. Propensity score-matched analysis compared patients who underwent immediate reconstruction (n = 5,256; stratified into implant and autologous groups), with those who did not (n = 5,256). Multivariate-adjusted extended Cox regression was used to assess lymphedema outcomes. Lymphedema incidences were similar between the immediate reconstruction (22.50%; 95% confidence interval [CI]: 19.60-25.30%) and no reconstruction groups (25.30%; 95% CI: 22.50-28.00%; P = 0.180). After adjusting for age, surgery type, treatments, and comorbidities, immediate reconstruction showed an inverse association with lymphedema (adjusted hazard ratio [HR], 0.76; 95% CI, 0.69-0.85). When stratified by reconstruction method, implant reconstruction exhibited a reduced risk (adjusted HR, 0.74; 95% CI, 0.67-0.82), while autologous reconstruction showed a higher risk (adjusted HR, 1.96; 95% CI, 1.39-2.78) for lymphedema. Immediate implant-based reconstruction may lower lymphedema risk, but interpretation requires caution due to potential selection bias, missing data on BMI, breast size, and applicability beyond East Asian populations. Further research with detailed patient information is needed to confirm clinical implications.
本研究评估了即刻乳房重建对被诊断为乳腺癌的女性淋巴水肿发生率的影响。我们纳入了自2017年以来接受乳腺癌治疗（国际疾病分类第十版原发性诊断编码C50）的45734名年龄≥30岁的女性。倾向评分匹配分析比较了接受即刻重建的患者（n = 5256；分为植入物组和自体组织组）与未接受即刻重建的患者（n = 5256）。采用多变量调整的扩展Cox回归来评估淋巴水肿结局。即刻重建组（22.50%；95%置信区间[CI]：19.60 - 25.30%）和未重建组（25.30%；95% CI：22.50 - 28.00%；P = 0.180）的淋巴水肿发生率相似。在调整年龄、手术类型、治疗方法和合并症后，即刻重建与淋巴水肿呈负相关（调整后风险比[HR]，0.76；95% CI，0.69 - 0.85）。按重建方法分层时，植入物重建显示淋巴水肿风险降低（调整后HR，0.74；95% CI，0.67 - 0.82），而自体组织重建显示淋巴水肿风险较高（调整后HR，1.96；95% CI，1.39 - 2.78）。基于植入物的即刻重建可能会降低淋巴水肿风险，但由于存在潜在的选择偏倚、体重指数、乳房大小数据缺失以及东亚人群以外的适用性问题，解释时需谨慎。需要进一步研究详细的患者信息以确认其临床意义。
