Oncological results of immediate breast reconstruction: long term follow-up of a large series at a single institution.
BACKGROUND
Reconstruction of the breast after mastectomy is an integral part of the complete management of breast cancer. However, a delay in the reconstruction is usually proposed after the mastectomy in case of invasive cancer, while there is a general agreement for immediate breast reconstruction in case of in situ tumors.


METHODS
Among a total of 677 patients having undergone a mastectomy between 1997 and 2001, 518 (76.5%) underwent an immediate breast reconstruction (IBR). All the patients had a Patey mastectomy for invasive cancer (T1-T3). An adjuvant medical treatment was given according to the biological characteristics of the tumor and lymph node status. No patient received any kind of radiotherapy. The median follow up was 70 months (range 13-114).


RESULTS
The local recurrence rate was 5.2% for the group of IBR and 9.4% for the mastectomy group without IBR (NoIBR). The regional metastases rate was 1.4 vs. 1.3%. The rate of distant metastases was 13.9 vs. 16.4%. Contra-lateral breast tumor was observed in 1.5 vs. 1.3%. Death rate was 10.4 vs. 16.4%. No statistical difference was observed between the two groups in terme of overall survival (OS) and disease free survival (DFS) (HR(IBR vs. NoIBR): 1.03 and 0.99 for OS and DFS, respectively).


CONCLUSIONS
At our institution we have compared a large series that have undergone IBR (518) with a control group (159) and followed over a prolonged period of time (70 months). This study provides the best available results to suggest that IBR is a safe and reliable treatment option for the managing invasive breast cancer.
Petit
J Y
JY
Department of Plastic Surgery, European Institute of Oncology, Milan, Italy. jean.petit@ieo.it
Gentilini
O
O
Rotmensz
N
N
Rey
P
P
Rietjens
M
M
Garusi
C
C
Botteri
E
E
De Lorenzi
F
F
Martella
S
S
Bosco
R
R
Khuthaila
D K
DK
Luini
A
A
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000601:surgery*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D016462:Mammaplasty / Q000379:methods*; D008408:Mastectomy / Q000379:methods; D008875:Middle Aged; D009362:Neoplasm Metastasis; D012008:Recurrence; D013997:Time Factors; D016896:Treatment Outcome