title: A Prospective Study on Skin-Sparing Mastectomy for Immediate Breast Reconstruction with Latissimus Dorsi Flap After Neoadjuvant Chemotherapy and Radiotherapy in Invasive Breast Carcinoma.
abstract: Skin-sparing mastectomy (SSM) with immediate breast reconstruction (IBR) is increasingly used in invasive breast cancer. However, adjuvant chemotherapy (CT) and radiotherapy (RT) can increase the rate of local complications.
  
  
  
  The aim of this study was to assess the morbidity of SSM-IBR after neoadjuvant CT and RT.
  
  
  
  A French prospective pilot study of women aged 18-75 years with invasive breast cancer requiring mastectomy after CT and RT. Reconstruction was performed using autologous latissimus dorsi flap with or without prosthesis. The primary endpoint was the skin necrosis rate within 6 months, while secondary endpoints included pathological complete response rate (pCR) and global morbidity.
  
  
  
  Among 94 patients included in this study, 83 were analyzed (mean age 45.2 ± 9.5 years, T1 23.6 %, T2 55.6 %, T3 18.1 %). All but one patient received anthracyclines and taxanes, and all patients received RT (49.3 ± 5.2 Gy) before SSM-IBR. Prostheses were used for IBR in 32 patients (mean volume 256 ± 73 mm(3)). Five patients had necrosis (≤2 cm(2), 2-10 cm(2) and >10 cm(2), in three, one, and one cases, respectively), and they all recovered without revision surgery. Among 50 patients who underwent upfront mastectomy, 36 % achieved pCR.
  
  
  
  SSM-IBR performed after CT and RT is safe, with an acceptable local morbidity rate. Long-term data are needed to evaluate recurrence rates.
authors.affiliation: Montpellier Institut du Sein, Clinique Clémentville, Montpellier, France. cecile.zinzindohoue@le-mis.fr.
authors.forename: Cécile
authors.identifier: 0000-0002-9840-266X
authors.initials: C
authors.lastname: Zinzindohoué
authors.affiliation: Montpellier Institut du Sein, Clinique Clémentville, Montpellier, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Bertrand
authors.affiliation: Montpellier Institut du Sein, Clinique Clémentville, Montpellier, France.|Epsylon EA 4556 Laboratory "Dynamics of Human Abilities & Health Behaviors", University Paul Valéry Montpellier 3, Montpellier, France.
authors.forename: Aude
authors.initials: A
authors.lastname: Michel
authors.affiliation: Montpellier Institut du Sein, Clinique Clémentville, Montpellier, France.
authors.forename: Emilie
authors.initials: E
authors.lastname: Monrigal
authors.affiliation: Polyclinique Urbain V, Avignon, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Miramand
authors.affiliation: Polyclinique Urbain V, Avignon, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Sterckers
authors.affiliation: Centre Léon Bérard, Lyon, France.
authors.forename: Christelle
authors.initials: C
authors.lastname: Faure
authors.affiliation: Institut Claudius Regaud, Toulouse Cedex 3, France.
authors.forename: Hélène
authors.initials: H
authors.lastname: Charitansky
authors.affiliation: Institut Du Cancer De Montpellier (ICM), Montpellier, France.
authors.forename: Marian
authors.initials: M
authors.lastname: Gutowski
authors.affiliation: Institut Paoli Calmettes, Marseille, France.
authors.forename: Monique
authors.initials: M
authors.lastname: Cohen
authors.affiliation: Institut Paoli Calmettes, Marseille, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Houvenaeghel
authors.affiliation: Montpellier Institut du Sein, Clinique Saint Roch, Montpellier, France.
authors.forename: Frederic
authors.initials: F
authors.lastname: Trentini
authors.affiliation: Centre Paul Papin, Angers, France.
authors.forename: Pedro
authors.initials: P
authors.lastname: Raro
authors.affiliation: UPRES 2415, Montpellier, France.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Daures
authors.affiliation: UPRES 2415, Montpellier, France.
authors.forename: Sandy
authors.initials: S
authors.lastname: Lacombe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D018270:Carcinoma, Ductal, Breast / Q000473:pathology / Q000601:surgery / Q000628:therapy; D018275:Carcinoma, Lobular / Q000473:pathology / Q000601:surgery / Q000628:therapy; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016462:Mammaplasty; D008408:Mastectomy; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009361:Neoplasm Invasiveness; D059351:Organ Sparing Treatments; D010865:Pilot Projects; D011379:Prognosis; D011446:Prospective Studies; D018714:Radiotherapy, Adjuvant; D064171:Superficial Back Muscles / Q000601:surgery*; D013524:Surgical Flaps; D055815:Young Adult