Clinical Outcome of Immediate Breast Reconstruction Using a Silicone Gel-filled Implant after Nipple-preserving Mastectomy.
In order to evaluate the safety of silicone gel-filled implants for breast reconstruction in terms of cancer control, we reviewed 122 patients with postoperative state I and II breast cancer who were treated by nipple-preserving mastectomy and immediate breast reconstruction using a silicone implant, and compared them with 92 controls treated by nipple-preserving mastectomy alone. Twelve complications requiring surgical management occurred in the 122 reconstructions(9.8%). Two implants were replaced, and 10 implants were removed. These 10 cases were excluded from survival analysis. The mean Follow-up duration was 78 months in the 112 patients with breast reconstruction, and 55 months in the controls. There were no significant differences in the overall, disease-free, and locoregional disease-free survival rates between the two groups. In the reconstruction group, recurrence occurred in 14 patients. Five of them had locoregional recurrence alone, and are surviving free of disease following local resection. By the last follow-up, there was no incidence of secondary cancer at any site, including the contralateral breast cancer or connective tissue disease in the both group. Our results do not support the hypothesis of a detrimental effect of breast reconstruction using silicone gel-filled implants after mastectomy for breast cancer.
Yoshimura
G
Department of Surgery, Kihoku Hospital, Wakayama Medical College, 219 Katsuragi, Ito-gun, Wakayama 649-71, Japan.
Sakurai
T
Oura
S
Tamaki
T
Umemura
T
Kokawa
Y