J Korean Breast Cancer Soc.  2004 Jun;7(2):126-131. 10.4048/jkbcs.2004.7.2.126.

Skin-sparing Mastectomy with Immediate Breast Reconstruction for the Treatment of Advanced Breast Cancer

• Hwang UK
• Yoon HS
• Kwak BS
• Son BH
• Ahn SH
• Lee TJ

• KMID: 1917900
• DOI: http://doi.org/10.4048/jkbcs.2004.7.2.126

Abstract

PURPOSE
This study was performed to show the several clinical variables before and after the surgery that need to be considered for patient selection and whether there is an increased possibility of recurrence after surgery and whether this possibility can be reduced when adjuvant treatment is applied. METHODS: The outcome of SSM with immediate breast reconstruction, using follow-up data of cases performed at Asan Medical Center between September, 1996 and December, 2002, were retrospectively assessed and pathologically advanced breast cancer patients (stage III) were analyzed separately. RESULTS: 191 patients had undergone SSM with immediate reconstruction during the study period. The percentage of cases stage III was 15.2% (29 cases). Among these patients, 6 (20.7%) were suspected of being in the early stages of breast cancer prior to the surgery. The mean age of the advanced breast cancer patients was 37 years. Immediate breast reconstruction consisted of a pedicled TRAM flap (n=24), a insertion of tissue expander (n=4) or direct implant (n=1). Radiotherapy was performed in 16 patients (53.3%) and chemotherapy was conducted without delay in all case. With a median length of follow-up of 36.1 months for 22 patients, who under went the operation until December, 2001, local recurrence was 4.5% (1/22) with successful local treatment, and distant metastasis was 13.7% (3/22). There was no difference in the disease free survival compared to that of the non-reconstruction group (P=0.093). CONCLUSION: SSM with immediate reconstruction seems safe and effective for patients with advanced breast cancer. However an accurate preoperative assessment of the extent of the disease and discussion for the planning of treatment between surgeon and patient is required.

Keyword

Skin-Sparing mastectomy; Advanced breast cancer; Immediate reconstruction

MeSH Terms

Breast Neoplasms*
Breast*
Chungcheongnam-do
Disease-Free Survival
Drug Therapy
Female
Follow-Up Studies
Humans
Mammaplasty*
Mastectomy*
Neoplasm Metastasis
Patient Selection
Radiotherapy
Recurrence
Retrospective Studies
Tissue Expansion Devices