Presentation, treatment, and outcome of local recurrence after skin-sparing mastectomy and immediate breast reconstruction

被引:181
作者
Newman, LA
Kuerer, HM
Hunt, KK
Kroll, SS
Ames, FC
Ross, MI
Feig, BW
Singletary, SE
机构
[1] Univ Texas, MD Anderson Cancer Ctr, Dept Surg Oncol, Houston, TX 77030 USA
[2] Univ Texas, MD Anderson Cancer Ctr, Dept Plast & Reconstruct Surg, Houston, TX 77030 USA
关键词
early stage breast cancer; immediate breast reconstruction; skin-sparing mastectomy;
D O I
10.1007/BF02303832
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background: The local recurrence (LR) rate with skin-sparing mastectomy (SSM) and immediate breast reconstruction (IBR) has been reported as comparable to the LR rate after conventional mastectomy. However, limited data are available on the prognostic significance and management of LR following SSM. Methods: A prospective database maintained at the University of Texas hi. D. Anderson Cancer Center identified 437 SSMs performed for 372 invasive T1/T2 breast cancers between 1986 and 1993. Results: Twenty-three LRs were identified, with a LR rate of 6.2% (23/372). Twenty-two of these (96%) presented as palpable skin-flap masses. The median time to recurrence was 25 months (range, 3 to 98 months). Fourteen patients were treated with a combination of surgery and systemic therapy. Resection of the reconstructed breast was performed in only three patients. Complete local control of the recurrent disease was achieved in 17 patients (74%). Nine patients (39%) developed distant metastatic disease. At a median follow-up of 26 months, 14 of 23 patients (61%) are alive without evidence of disease, and 7 (30%) have died from breast cancer. Conclusions: Because LR rate with SSM is low and likelihood of local control and survival is high, SSM and IBR is an acceptable treatment option for early stage breast cancer.
引用
收藏
页码:620 / 626
页数:7
相关论文
共 19 条
[1]  
AMES FC, 1990, SURG CLIN N AM, V70, P1115
[2]  
ANDRY G, 1989, EUR J SURG ONCOL, V15, P476
[3]   GLANDULAR EXCISION IN TOTAL GLANDULAR MASTECTOMY AND MODIFIED RADICAL-MASTECTOMY - A COMPARISON [J].
BARTON, FE ;
ENGLISH, JM ;
KINGSLEY, WB ;
FIETZ, M .
PLASTIC AND RECONSTRUCTIVE SURGERY, 1991, 88 (03) :389-392
[4]   LOCAL OR REGIONALLY RECURRENT CARCINOMA OF THE BREAST - RESULTS OF THERAPY IN 121 PATIENTS [J].
BECK, TM ;
HART, NE ;
WOODARD, DA ;
SMITH, CE .
JOURNAL OF CLINICAL ONCOLOGY, 1983, 1 (06) :400-405
[5]   FIRST ISOLATED LOCOREGIONAL RECURRENCE FOLLOWING MASTECTOMY FOR BREAST-CANCER - RESULTS OF A PHASE-III MULTICENTER STUDY COMPARING SYSTEMIC TREATMENT WITH OBSERVATION AFTER EXCISION AND RADIATION [J].
BORNER, M ;
BACCHI, M ;
GOLDHIRSCH, A ;
GREINER, R ;
HARDER, F ;
CASTIGLIONE, M ;
JUNGI, WF ;
THURLIMANN, B ;
CAVALLI, F ;
OBRECHT, JP ;
LEYVRAZ, S ;
ALBERTO, P ;
ADAM, H ;
VARINI, M ;
LOEHNERT, T ;
SENN, HJ ;
METZGER, U ;
BRUNNER, K .
JOURNAL OF CLINICAL ONCOLOGY, 1994, 12 (10) :2071-2077
[6]   Skin-sparing mastectomy - Oncologic and reconstructive considerations [J].
Carlson, GW ;
Bostwick, J ;
Styblo, TM ;
Moore, B ;
Bried, JT ;
Murray, DR ;
Wood, WC .
ANNALS OF SURGERY, 1997, 225 (05) :570-575
[7]   5-YEAR RESULTS OF A RANDOMIZED CLINICAL-TRIAL COMPARING TOTAL MASTECTOMY AND SEGMENTAL MASTECTOMY WITH OR WITHOUT RADIATION IN THE TREATMENT OF BREAST-CANCER [J].
FISHER, B ;
BAUER, M ;
MARGOLESE, R ;
POISSON, R ;
PILCH, Y ;
REDMOND, C ;
FISHER, E ;
WOLMARK, N ;
DEUTSCH, M ;
MONTAGUE, E ;
SAFFER, E ;
WICKERHAM, L ;
LERNER, H ;
GLASS, A ;
SHIBATA, H ;
DECKERS, P ;
KETCHAM, A ;
OISHI, R ;
RUSSELL, I .
NEW ENGLAND JOURNAL OF MEDICINE, 1985, 312 (11) :665-673
[8]  
FISHER B, 1977, CANCER-AM CANCER SOC, V39, P2827, DOI 10.1002/1097-0142(197706)39:6<2827::AID-CNCR2820390671>3.0.CO
[9]  
2-I
[10]   THE IMPLICATIONS OF LOCAL RECURRENCE OF BREAST-CANCER AS THE 1ST SITE OF THERAPEUTIC FAILURE [J].
GILLILAND, MD ;
BARTON, RM ;
COPELAND, EM .
ANNALS OF SURGERY, 1983, 197 (03) :284-287