Abstract
ObjectiveImmediate reconstruction (IR) is a safe and effective surgical treatment for patients with breast cancer. We aimed to assess the prognosis, aesthetic outcomes, and patient satisfaction of IR compared with breast conservation surgery (BCS) and total mastectomy (TM).MethodsThis retrospective matched-cohort study was conducted between May 2005 and December 2014. We established two cohorts according to the tumor (T) size of breast cancer. In the T≤3cm group, cases (IR) and controls (BCS or TM) were matched for age, pathological tumor size, and pathologic nodal status in a 1:1:1 ratio. In the T>3cm group, cases (IR) and controls (TM) were matched with the same factors and ratio. The primary outcome was the 5-year disease-free survival (DFS). The secondary outcome was patient satisfaction and quality of life.ResultsA total of 12,678 breast cancer patients were assessed for eligibility, of which 587 were included (T≤3 cm group: 155 IR vs 155 BCS vs 155 TM; T>3cm group: 61 IR vs 61 TM). In the T≤3 cm cohort, patients who underwent IR had no difference compared with those who underwent BCS or TM regarding the 5-year DFS (P=0.539); however, an improved aesthetic satisfaction, psychosocial, and sexual well-being were achieved in the IR group (P<0.001). In the T>3 cm cohort, the IR group had a worse median 5-year DFS (P=0.044), especially for Her2+ or triple-negative breast carcinoma (TNBC) subtypes compared with the TM group.ConclusionsIR improves aesthetic satisfaction, psychosocial, and sexual well-being for breast cancer patients with T≤3 cm. For patients with T > 3 cm invasive breast cancer, TM is superior to IR as it predicts a better 5-year DFS.
Highlights
Breast cancer is the most common malignant disease among women worldwide, with an incidence varies between 27 in 100,000 (Africa and East Asia) and 97 in 100,000 (North America) worldwide [1]
We examined the association between cancer subtypes and the 5-year disease-free survival (DFS) of Immediate reconstruction (IR) in both T≤3 cm and T>3 cm groups
A total of 12,678 consecutive breast cancer patients who underwent various surgical procedures were extracted from the HMUCH database for the eligibility assessment, of which 216 cases underwent IR (155 cases in the T ≤ 3 cm group vs 61 cases in the T > 3cm group) meeting the study criteria were included in the final analysis. 155 cases of breast conservation surgery (BCS) and 155 of total mastectomy (TM) were matched with 155 cases of IR in the T ≤ 3 cm group, of which 118 performed breast implant (IRBI) (Fig. 2A) and 37 performed autologous tissue (IRAT) (Fig. 2B)
Summary
Breast cancer is the most common malignant disease among women worldwide, with an incidence varies between 27 in 100,000 (Africa and East Asia) and 97 in 100,000 (North America) worldwide [1]. IR can benefit patients both physically and psychologically when compared with TM and BCS. A previous match-cohort study has identified several associated factors that can predict the prognosis of breast cancer for patients who underwent BCS [10]. No studies systematically assessed the long-term oncologic follow-up outcomes of IR applied for patients with different lesion sizes. Whether breast cancer patients with different molecular subtypes can benefit from IR remains unclear. Some previous studies have reported improved the quality of life and satisfying aesthetic outcomes for patients who underwent either BCS or TM, no matter whether with or without reconstruction [11,12,13,14,15], direct comparisons with respect to survival and safety outcomes between IR, BCS and TM are scarce
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
