Oncologic Safety of Immediate Breast Reconstruction in Breast Cancer Patients Who Underwent Neoadjuvant Chemotherapy: Short-Term Outcomes of a Matched Case–Control Study

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Abstract

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.

Micro-Abstract:

We analyzed oncologic outcome by matching variables including age and clinical T and N stage before immediate breast reconstruction (IBR) after neoadjuvant chemotherapy (NACT), response to NACT, and pathologic stage after NACT. IBR after skin-sparing mastectomy or nipple-sparing mastectomy may be a feasible surgical treatment option even in breast cancer patients who underwent NACT.

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