Abstract P4-13-05: Detection of local recurrence in premenopausal patients treated with neoadjuvant chemotherapy and mastectomy with or without breast reconstruction

Abstract

Abstract Background: Women who undergo mastectomy for breast cancer treatment often undergo implant based or autologous reconstruction. There are limited data, however, as to whether reconstruction may interfere with detection of a locoregional recurrence. The goal of this study was to assess whether women who undergo reconstruction after mastectomy have an increased risk of local recurrence and/or longer time to local recurrence detection. Methods: One hundred and fifty-four premenopausal patients who underwent neoadjuvant chemotherapy followed by mastectomy were identified between 2005 and 2015. Patients with de novo Stage IV disease or insufficient medical records were excluded from analysis. Patient and treatment variables were collected, including clinical stage, type of chemotherapy, type of surgery and reconstruction, use of postmastectomy radiotherapy, and use of endocrine therapy. Local recurrence (LR) was defined as a chest wall or skin recurrence. Regional failure (RF) was defined as recurrence in the axilla, supraclavicular fossa, or internal mammary nodes. Results: The median follow up for this cohort was 49.9 months. Of the 154 patients, 71 (46%) underwent unilateral mastectomy and 83 (54%) underwent bilateral mastectomies. Thirty patients (19%) elected to forgo reconstruction while 78 (51%) received tissue expander/implant based reconstruction, 29 (19%) received autologous reconstruction, and 17 (11%) had unknown reconstruction histories. Patients who had reconstruction had an increased time to detection of a LR compared to those without reconstruction (p=0.048). However, controlling for the T and N stage of disease, Cox regression demonstrated no observable difference in risk for LR between patients who underwent reconstruction compared to those who didn't. There was no difference in detection of RF between those with and without reconstruction (p=0.092). Conclusions: Premenopausal patients treated with neoadjuvant chemotherapy followed by mastectomy with any type of reconstructive surgery had an increased time to local recurrence detection compared to those without reconstruction. There was no difference in the risk for local recurrence between those who underwent reconstruction compared to those who didn't. Citation Format: Jacobson CE, Kozak M, Walck E, Hawley E, Horst K. Detection of local recurrence in premenopausal patients treated with neoadjuvant chemotherapy and mastectomy with or without breast reconstruction [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P4-13-05.