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Immediate breast reconstruction in locally advanced breast cancer: is it safe?

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Abstract

Purpose

Immediate breast reconstruction (IBR) following mastectomy remains controversial for locally advanced breast cancer over concerns regarding recurrence and complications which may delay adjuvant therapies. This study aimed to compare the oncologic outcomes and surgical safety of IBR following mastectomy with mastectomy alone (MA) for locally advanced breast cancer.

Methods

All patients treated at the Providence Breast Center between 2012 and 2017 for biopsy-proven locally advanced breast cancer, AJCC (8th edition) clinical stages (IIB–IIIC), were included. Primary outcomes were overall survival (OS), disease-specific survival (DSS), and disease-free survival (DFS). Secondary outcomes included recurrence rate, adjuvant therapy use, and reoperation.

Results

267 patients (112 IBR, 155 MA) were included. On average, IBR patients were younger (48.82 years vs 61.42 years, P < 0.001). Median study follow-up was 50.7 months. OS was higher among IBR patients (86.6% vs 73.5%, P < 0.05). However, no significant differences were found in DSS (87.5% vs 84.5%, P = 0.34), DFS (79.5% vs 78.7%, P = 0.55), local recurrence (0% vs 1.9%, P = 0.194), adjuvant therapy use (95.5% vs 91.6%, P = 0.155), or reoperation (1.8% vs 1.3%, P = 0.559).

Conclusion

IBR is a safe option for patients with locally advanced breast cancer and does not negatively impact survival, cancer recurrence rates, and use of adjuvant therapy.

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Data availability

All data were retrieved from a prospectively maintained hospital database.

Code availability

Analysis was performed using R and RStudio.

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Acknowledgements

The authors would like to acknowledge the physicians in the Department of Surgery at Providence Health Care for their input in this study.

Funding

The authors received no funding for the project.

Author information

Authors and Affiliations

  1. Division of General Surgery, Department of Surgery, Providence Health Care Breast Centre, Providence Breast Centre & University of British Columbia, Mount Saint Joseph Hospital, 3rd Floor, 3080 Prince Edward Street, Vancouver, BC, V5T 3N4, Canada

    Jin-Si Pao, Crystal Ma, Mabel Zhang, Elaine McKevitt, Amy Bazzarelli, Carol Dingee & Rebecca Warburton

  2. Department of Surgery, Division of General Surgery, University of British Columbia Faculty of Medicine, Vancouver, BC, Canada

    Kadhim Taqi, Jin-Si Pao, Leo Chen, Elaine McKevitt, Amy Bazzarelli & Carol Dingee

Authors
  1. Kadhim Taqi
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  2. Jin-Si Pao
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  3. Leo Chen
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  4. Crystal Ma
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  5. Mabel Zhang
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  6. Elaine McKevitt
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  7. Amy Bazzarelli
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  8. Carol Dingee
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  9. Rebecca Warburton
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by KT, JSP, LC, CM, and MZ. The first draft of the manuscript was written by KT and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Rebecca Warburton.

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Conflict of interest

The authors report no proprietary or commercial interest in any product mentioned or concept discussed in this article.

Ethical approval

Approved by the University of British Columbia and Providence Health Care research ethics boards.

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Taqi, K., Pao, JS., Chen, L. et al. Immediate breast reconstruction in locally advanced breast cancer: is it safe?. Breast Cancer Res Treat 190, 175–182 (2021). https://doi.org/10.1007/s10549-021-06366-6

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  • DOI: https://doi.org/10.1007/s10549-021-06366-6

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