Breast cancer recurrence following postmastectomy reconstruction compared to mastectomy with no reconstruction

Sashank Reddy, Salih Colakoglu, Michael S. Curtis, Janet H. Yueh, Adeyemi Ogunleye, Adam M. Tobias, Bernard T. Lee

Research output: Contribution to journalArticle

Abstract

Background: Continuing advances in breast reconstruction have provided surgeons with a multitude of reconstructive options. Concerns remain, however, about the effects of the various reconstructive methods on ultimate oncologic outcome. This study compares incidence, detection, and management of recurrent breast cancer in a large series of patients treated with mastectomy alone or with mastectomy and various forms of reconstruction. Methods: A retrospective analysis was performed on all patients who underwent mastectomy and/or immediate reconstruction for breast cancer at our institution between January 1999 and December 2006. The 921 patients were divided into 2 groups: mastectomy and reconstruction (n = 494) and mastectomy alone (n = 427). All modern reconstructive methods were included. Patients were followed for a mean of 4.5 years. Results: The total incidence of recurrence-locoregional and/or distant-was 5.9% in patients who had mastectomy with reconstruction and 11.5% in patients who had mastectomy alone (P < 0.0023). The incidence of locoregional recurrence only was 2.2% in patients who had mastectomy with reconstruction and 4.0% in patients who had mastectomy alone (P = 0.1220). Of the 11 reconstructed patients with a locoregional recurrence, all recurrences were detected by self or clinical examination. Median time to detection was the same in both groups: 1.6 years (P = 0.5471). Conclusions: Reconstruction with a variety of methods does not adversely affect the incidence or time to detection of recurrent breast cancer. Further, our data point to an important role for physical examination in tumor surveillance after mastectomy and reconstruction.

Original languageEnglish (US)
Pages (from-to)466-471
Number of pages6
JournalAnnals of Plastic Surgery
Volume66
Issue number5
DOIs
StatePublished - May 1 2011
Externally publishedYes

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Mastectomy
Breast Neoplasms
Recurrence
Incidence
Mammaplasty
Physical Examination
Cohort Studies

Keywords

  • breast cancer
  • Breast reconstruction
  • cancer recurrence

ASJC Scopus subject areas

  • Surgery

Cite this

Breast cancer recurrence following postmastectomy reconstruction compared to mastectomy with no reconstruction. / Reddy, Sashank; Colakoglu, Salih; Curtis, Michael S.; Yueh, Janet H.; Ogunleye, Adeyemi; Tobias, Adam M.; Lee, Bernard T.

In: Annals of Plastic Surgery, Vol. 66, No. 5, 01.05.2011, p. 466-471.

Research output: Contribution to journalArticle

Reddy, Sashank ; Colakoglu, Salih ; Curtis, Michael S. ; Yueh, Janet H. ; Ogunleye, Adeyemi ; Tobias, Adam M. ; Lee, Bernard T. / Breast cancer recurrence following postmastectomy reconstruction compared to mastectomy with no reconstruction. In: Annals of Plastic Surgery. 2011 ; Vol. 66, No. 5. pp. 466-471.
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abstract = "Background: Continuing advances in breast reconstruction have provided surgeons with a multitude of reconstructive options. Concerns remain, however, about the effects of the various reconstructive methods on ultimate oncologic outcome. This study compares incidence, detection, and management of recurrent breast cancer in a large series of patients treated with mastectomy alone or with mastectomy and various forms of reconstruction. Methods: A retrospective analysis was performed on all patients who underwent mastectomy and/or immediate reconstruction for breast cancer at our institution between January 1999 and December 2006. The 921 patients were divided into 2 groups: mastectomy and reconstruction (n = 494) and mastectomy alone (n = 427). All modern reconstructive methods were included. Patients were followed for a mean of 4.5 years. Results: The total incidence of recurrence-locoregional and/or distant-was 5.9{\%} in patients who had mastectomy with reconstruction and 11.5{\%} in patients who had mastectomy alone (P < 0.0023). The incidence of locoregional recurrence only was 2.2{\%} in patients who had mastectomy with reconstruction and 4.0{\%} in patients who had mastectomy alone (P = 0.1220). Of the 11 reconstructed patients with a locoregional recurrence, all recurrences were detected by self or clinical examination. Median time to detection was the same in both groups: 1.6 years (P = 0.5471). Conclusions: Reconstruction with a variety of methods does not adversely affect the incidence or time to detection of recurrent breast cancer. Further, our data point to an important role for physical examination in tumor surveillance after mastectomy and reconstruction.",
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