Objective:The number of immediate breast reconstruction(IBR)procedures has been increasing in China.This study aimed to investigate the oncological safety of IBR,and to compare the survival and surgical outcomes betwe...Objective:The number of immediate breast reconstruction(IBR)procedures has been increasing in China.This study aimed to investigate the oncological safety of IBR,and to compare the survival and surgical outcomes between implant-based and autologous reconstruction.Methods:Data from patients diagnosed with invasive breast cancer who underwent immediate total breast reconstruction between 2001 and 2016 were retrospectively reviewed.Long-term breast cancer-specific survival(BCSS),disease-free survival(DFS),and locoregional recurrence-free survival(LRFS)were evaluated.Patient satisfaction with the breast was compared between the implantbased and autologous groups.BCSS,DFS,and LRFS were compared between groups after propensity score matching(PSM).Results:A total of 784 IBR procedures were identified,of which 584 were performed on patients with invasive breast cancer(implantbased,n=288;autologous,n=296).With a median follow-up of 71.3 months,the 10-year estimates of BCSS,DFS,and LRFS were 88.9%[95%confidence interval(CI)(85.1%–93.0%)],79.6%[95%CI(74.7%–84.8%)],and 94.0%[95%CI(90.3%–97.8%)],respectively.A total of 124 patients completed the Breast-Q questionnaire,and no statistically significant differences were noted between groups(P=0.823).After PSM with 27 variables,no statistically significant differences in BCSS,DFS,and LRFS were found between the implant-based(n=177)and autologous(n=177)groups.Further stratification according to staging,histological grade,lymph node status,and lymph-venous invasion status revealed no significant survival differences between groups.Conclusions:Both immediate implant-based and autologous reconstruction were reasonable choices with similar long-term oncological outcomes and patient-reported satisfaction among patients with invasive breast cancer in China.展开更多
目的:探讨局部晚期乳腺癌(locally advanced breast cancer,LABC)行即刻乳房再造术(immediate breast reconstruction,IBR)的肿瘤学安全性。方法:回顾性分析2001年9月至2016年3月于天津医科大学肿瘤医院被诊断为LABC并行IBR的114例患者...目的:探讨局部晚期乳腺癌(locally advanced breast cancer,LABC)行即刻乳房再造术(immediate breast reconstruction,IBR)的肿瘤学安全性。方法:回顾性分析2001年9月至2016年3月于天津医科大学肿瘤医院被诊断为LABC并行IBR的114例患者的临床资料,分析总体生存(overall survival,OS)率、无局部复发生存(local recurrence-free survival,LRFS)率和无远处转移生存(distant metastasis-free survival,DMFS)率。采用Cox比例风险回归模型分析影响预后的因素。结果:中位随访时间为55.0个月,总队列5年OS率、LRFS率和DMFS率分别为78.9%(95%CI:69.1%~85.9%)、95.8%(95%CI:89.2%~98.4%)和78.9%(95%CI:69.1%~86.0%)。肿瘤直径>5 cm较肿瘤直径≤5 cm患者更易局部复发(P=0.023)。Cox比例风险回归模型多因素分析显示,肿瘤直径>5 cm(HR=3.60,95%CI:1.40~9.10,P=0.007)与淋巴结病理分期N3(HR=4.20,95%CI:1.60~11.0,P=0.004)是患者死亡的独立危险因素。结论:LABC行IBR术式的总体肿瘤学安全性可靠。肿瘤直径>5 cm或淋巴结病理分期为N3的LABC患者应慎行IBR。展开更多
基金supported by the Tianjin“Belt and Road”Technological Innovation and Cooperation Grant(Grant No.18PTZWHZ00050)the Special Foundation for Project and Team Development Grant(Grant No.XB202008).
文摘Objective:The number of immediate breast reconstruction(IBR)procedures has been increasing in China.This study aimed to investigate the oncological safety of IBR,and to compare the survival and surgical outcomes between implant-based and autologous reconstruction.Methods:Data from patients diagnosed with invasive breast cancer who underwent immediate total breast reconstruction between 2001 and 2016 were retrospectively reviewed.Long-term breast cancer-specific survival(BCSS),disease-free survival(DFS),and locoregional recurrence-free survival(LRFS)were evaluated.Patient satisfaction with the breast was compared between the implantbased and autologous groups.BCSS,DFS,and LRFS were compared between groups after propensity score matching(PSM).Results:A total of 784 IBR procedures were identified,of which 584 were performed on patients with invasive breast cancer(implantbased,n=288;autologous,n=296).With a median follow-up of 71.3 months,the 10-year estimates of BCSS,DFS,and LRFS were 88.9%[95%confidence interval(CI)(85.1%–93.0%)],79.6%[95%CI(74.7%–84.8%)],and 94.0%[95%CI(90.3%–97.8%)],respectively.A total of 124 patients completed the Breast-Q questionnaire,and no statistically significant differences were noted between groups(P=0.823).After PSM with 27 variables,no statistically significant differences in BCSS,DFS,and LRFS were found between the implant-based(n=177)and autologous(n=177)groups.Further stratification according to staging,histological grade,lymph node status,and lymph-venous invasion status revealed no significant survival differences between groups.Conclusions:Both immediate implant-based and autologous reconstruction were reasonable choices with similar long-term oncological outcomes and patient-reported satisfaction among patients with invasive breast cancer in China.
