Introduction: Although the indication for immediate breast reconstruction (IBR) after skin-sparing mastectomy (SSM) or nipple-sparing mastectomy (NSM) has been expanded, IBR after neoadjuvant chemotherapy (NACT) is still controversial. We conducted retrospective matched case-control study to analyze oncologic outcomes between patients who underwent TM only and those who underwent IBR after SSM or NSM after NACT.
Patients and methods: A retrospective review of breast cancer patients who underwent IBR after SSM or NSM after NACT between 2008 and 2015 at a single center was conducted. These cases were maximally matched by 1:5 to patients who underwent total mastectomy (TM) alone after NACT. Matching variables included age, clinical T and N stage before NACT, response to NACT, and pathologic stage after NACT. Pathologic stage followed the 7th edition of the American Joint Committee on Cancer (AJCC) classification.
Results: Overall, 31 patients were enrolled onto the IBR after SSM or NSM group (study group) and matched to 85 patients (control group). In the study group, 13 patients (41.9%) underwent NSM and 18 (58.1%) underwent SSM. Median follow-up duration was 29.2 (range, 7-31) and 38.8 (range, 11-85) months for the study and control groups (P = .012), respectively, and median age was 37.0 (range, 26-57) and 40.0 (range, 24-56) years (P = .890), respectively. Overall survival (P = .971), disease-free survival (P = .520), distant metastasis-free survival (P = .795), and local recurrence-free survival (P = .628) did not differ significantly between the 2 groups.
Conclusion: IBR after SSM or NSM might be a feasible surgical treatment option even in breast cancer patients who underwent NACT.
Keywords: Breast cancer; Breast reconstruction; Chemotherapy; Neoadjuvant treatment; Subcutaneous mastectomy.
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