title: Clinical outcome of reconstruction with tissue expanders for patients with breast cancer and mastectomy.
abstract: BACKGROUND
  Because the number of patients with breast cancer who have reconstruction after mastectomy is increasing, we analyzed the outcomes of reconstruction with tissue expanders (TEs).
  
  
  METHODS
  From 2004 to 2009, 133 patients with unilateral primary breast cancer who required mastectomy concurrent with reconstruction using TEs (TE group) and 308 patients with breast cancer who underwent mastectomy without reconstruction (MT group) were examined.
  
  
  RESULTS
  The median follow-up period was 47 months versus 44 months (TE group vs. MT group, respectively). The median age was 46 years in the TE group and 58 years in the MT group (P < .0001). The rate of hormone receptor positivity in the TE group was significantly higher than in the MT group (P = .0123). The incidence of local recurrence, time to detection of local recurrence, and size of tumor in local recurrence in the TE group and the MT group were 3.8% versus 1.6% (P = .1560), 17.2 months versus 12.4 months (P = .9166), and 1.9 cm versus 2.4 cm (P = .6742), respectively. In the TE versus the MT groups, relapse-free survival (RFS) and overall survival (OS) at 45 months were 89.0% versus 87.9% (P = .8706) and 93.9% versus 94.2% (P = .9947), respectively. The incidence of infection was significantly higher in the TE group than in the MT group-14.3 % versus 2.9%, respectively (P < .0001).
  
  
  CONCLUSIONS
  Compared with mastectomy alone, immediate reconstruction with TEs did not impair prognosis or contribute to a delay in detection of local recurrence, although the incidence of surgical site infection in the TE group was significantly higher than in the MT group.
authors.affiliation: Department of Breast and Endocrine Surgery, Mitsui Memorial Hospital, Tokyo, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ota
authors.affiliation: Department of Breast and Endocrine Surgery, Mitsui Memorial Hospital, Tokyo, Japan. Electronic address: fukuuchi@mitsuihosp.or.jp.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Fukuuchi
authors.affiliation: Breast Surgery Clinic, Tokyo, Japan.
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Iwahira
authors.affiliation: Department of Breast and Endocrine Surgery, Mitsui Memorial Hospital, Tokyo, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Kato
authors.affiliation: Department of Breast and Endocrine Surgery, Mitsui Memorial Hospital, Tokyo, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Takeuchi
authors.affiliation: Department of Breast Surgery, Totsuka Kyoritsu First Hospital, Yokohama, Japan.
authors.forename: Joji
authors.initials: J
authors.lastname: Okamoto
authors.affiliation: Department of Breast and Endocrine Surgery, Mitsui Memorial Hospital, Tokyo, Japan.
authors.forename: Tsunehiro
authors.initials: T
authors.lastname: Nishi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D016462:Mammaplasty / Q000009:adverse effects* / Q000295:instrumentation; D008408:Mastectomy; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D011379:Prognosis; D013530:Surgical Wound Infection / Q000453:epidemiology; D015625:Tissue Expansion Devices / Q000009:adverse effects*; D016896:Treatment Outcome
keywords: Breast cancer; Local recurrence; Overall survival; Reconstruction; Tissue expander