title: Oncologic Outcomes after Immediate Breast Reconstruction Following Total Mastectomy in Patients with Breast Cancer: A Matched Case-Control Study.
abstract: OBJECTIVE
  The use of immediate breast reconstruction (IBR) following total mastectomy (TM) has increased markedly in patients with breast cancer. As the indications for IBR have been broadened and more breast-conserving surgery-eligible patients are undergoing IBR, comparing the oncologic safety between TM only and IBR following TM becomes more difficult. This study aimed to analyze the oncologic outcomes between TM only and IBR following TM via a matched case-control methodology.
  
  
  METHODS
  A retrospective review was conducted to identify all patients who underwent TM between 2008 and 2014. We excluded patients who underwent neoadjuvant chemotherapy, including palliative chemotherapy, and had a follow-up duration <12 months, inflammatory breast cancer, or incomplete data. We divided the remaining patients into two groups: those who underwent TM only (control group) and those who underwent IBR following TM (study group). The groups were propensity score-matched. Matched variables included age, pathologic stage, estrogen or progesterone receptor status, human epidermal growth factor receptor 2 status, and year of operation.
  
  
  RESULTS
  After matching, 878 patients were enrolled in the control group and 580 patients in the study group. The median follow-up duration was 43.4 months (range, 11-100 months) for the control group and 41.3 months (range, 12-100 months) for the study group (p=1.000). The mean age was 47.3±8.46 years for the control group and 43.9±7.14 years for the study group (p>0.050). Matching was considered successful for the matching variables and other factors, such as family history, histology, multiplicity, and lymphovascular invasion. There were no significant differences in overall survival (log-rankp=0.454), disease-free survival (log-rankp=0.186), local recurrence-free survival (log-rankp=0.114), or distant metastasis-free survival rates (logrankp=0.537) between the two groups.
  
  
  CONCLUSIONS
  Our results suggest that IBR following TM is a feasible treatment option for patients with breast cancer.
authors.affiliation: Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Jai Min
authors.initials: JM
authors.lastname: Ryu
authors.affiliation: Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Hyun-June
authors.initials: HJ
authors.lastname: Paik
authors.affiliation: Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Sungmin
authors.initials: S
authors.lastname: Park
authors.affiliation: Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Ha Woo
authors.initials: HW
authors.lastname: Yi
authors.affiliation: Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Seok Jin
authors.initials: SJ
authors.lastname: Nam
authors.affiliation: Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Seok Won
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Se Kyung
authors.initials: SK
authors.lastname: Lee
authors.affiliation: Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Jonghan
authors.initials: J
authors.lastname: Yu
authors.affiliation: Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Soo Youn
authors.initials: SY
authors.lastname: Bae
authors.affiliation: Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Jeong Eon
authors.initials: JE
authors.lastname: Lee
keywords: Breast neoplasms; Mammaplasty; Treatment outcome