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Is mastectomy with immediate reconstruction safe for patients undergoing neoadjuvant chemotherapy? A nationwide study from Korean Breast Cancer Society

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Abstract

Purpose

In this study, we compared the prognoses of patients who underwent mastectomy with immediate breast reconstruction (IBR) after neoadjuvant chemotherapy with those who underwent mastectomy.

Methods

This retrospective study included 87,995 patients who were surgically treated for primary breast cancer between 2008 and 2014. We compared the three groups of patients who were divided based on the following surgeries: breast-conserving surgery (BCS), mastectomy, and mastectomy with IBR.

Results

Of the 3295 patients who were treated with neoadjuvant chemotherapy, 482 patients achieved a pathological complete response (pCR) and 2813 patients did not (non-pCR). In survival analysis of the pCR patients, the 5-year Overall Survival (5 yr OS) between those who underwent mastectomy with IBR and mastectomy (P = 0.639) In the non-pCR group, 5 yr OS of the mastectomy with IBR group was 90.0%, while those of the mastectomy group was 84.4% in patients with clinical stage II (P = 0.032). In a multivariate analysis by Cox regression method revealed that the prognoses of the patients who underwent mastectomy with IBR were not different from those of patients who underwent mastectomy group in both groups (the pCR group and the non-pCR group).

Conclusion

In the pCR group, the prognoses of patients who underwent mastectomy with IBR were not different from those of patients who underwent mastectomy. In the non-pCR group, women in the mastectomy with IBR group had shown worse prognoses than the mastectomy group in advanced clinical stage. Appropriate operation should be determined depending on the status of individualized patients.

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Acknowledgements

This article was supported by the research grant of the Korean Breast Cancer Society and the Chungbuk National University Hospital in 2019.

Author information

Authors and Affiliations

  1. Department of Breast Surgery, Chungbuk National University Hospital, College of Medicine, Chungbuk National University, Cheongju-si, Republic of Korea

    Sungmin Park & Young Jin Choi

  2. Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea

    Joon Jeong

  3. Department of Breast Surgery, Seoul National University Hospital, College of Medicine, Seoul National University, Seoul, Republic of Korea

    Wonshik Han

  4. Division of Breast Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea

    Young Joo Lee

  5. Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Republic of Korea

    Hyun-Ah Kim

  6. Department of Surgery, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea

    Seokwon Lee

  7. Department of Surgery, Dong-A University Hospital, Dong-A University College of Medicine, Busan, Republic of Korea

    Kyung Do Byun

  8. Department of Breast Surgery, Daerim St. Mary’s Hospital, Seoul, Republic of Korea

    Jiyoung Kim

  9. Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea

    Soo Youn Bae

  10. Division of Breast and Endocrine Surgery, Department of Surgery, Korea University Hospital, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 02841, Korea

    Soo Youn Bae

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  1. Sungmin Park
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  2. Joon Jeong
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Corresponding author

Correspondence to Soo Youn Bae.

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The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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For this type of study, informed consent was not required.

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Park, S., Jeong, J., Han, W. et al. Is mastectomy with immediate reconstruction safe for patients undergoing neoadjuvant chemotherapy? A nationwide study from Korean Breast Cancer Society. Breast Cancer 28, 874–883 (2021). https://doi.org/10.1007/s12282-021-01223-2

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  • DOI: https://doi.org/10.1007/s12282-021-01223-2

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