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Annals of Surgical Oncology

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01-03-2012 | Breast Oncology

Skin-Sparing Mastectomy and Immediate Autologous Breast Reconstruction in Locally Advanced Breast Cancer Patients: A UBC Perspective

Authors: Adelyn L. Ho, MD, MPH, Scott Tyldesley, MD, Sheina A. Macadam, MD, MSc, Peter A. Lennox, MD

Published in: Annals of Surgical Oncology | Issue 3/2012

Abstract

Purpose

To describe the clinical outcomes of patients with locally advanced breast cancer (LABC) receiving neoadjuvant chemotherapy and preoperative radiotherapy, followed by skin-sparing mastectomy (SSM) and immediate autologous breast reconstruction (IABR).

Methods

A retrospective review of 30 LABC patients who underwent SSM and IABR between 1997 to 2007 was performed. Data were drawn from patient records and the University of British Columbia (UBC) Breast Reconstruction and British Columbia Cancer Agency databases.

Results

All 30 patients received neoadjuvant chemotherapy, preoperative radiotherapy, SSM, and IABR. Fifteen patients (50%) had stage IIIA disease, 13 (43%) stage IIIB, and 2 (6.7%) stage IIIC. Reconstruction types included the pedicled transverse rectus myocutaneous flap (n = 24), the latissimus dorsi flap (n = 5), and a combination of transverse rectus myocutaneous and latissimus dorsi flap (n = 1). The median follow-up was 3.51 years (range 1–9.4 years). Local complications included mastectomy flap necrosis (n = 3), partial flap necrosis (n = 1), fat necrosis (n = 1), seroma (n = 3), infection (n = 2), and flap fibrosis (n = 1). The incidence of donor site complications was 20%. Overall 5-year actuarial locoregional relapse-free, distant relapse-free, and disease-specific survival rates were 80, 65, and 68%, respectively. Excellent or good physician-rated aesthetic results were achieved in 66% of patients.

Conclusions

The UBC protocol avoids irradiation of the autologous breast reconstruction. Outcomes compare with findings from similar studies with respect to local recurrence, distant relapse, overall survival, and surgical complication rates. Neoadjuvant chemotherapy and preoperative radiotherapy in LABC patients desiring autologous breast reconstruction can be considered a safe option.

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Title: Skin-Sparing Mastectomy and Immediate Autologous Breast Reconstruction in Locally Advanced Breast Cancer Patients: A UBC Perspective
Authors: Adelyn L. Ho, MD, MPH
Scott Tyldesley, MD
Sheina A. Macadam, MD, MSc
Peter A. Lennox, MD
Publication date: 01-03-2012
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 3/2012
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-011-1989-4

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Springer Medicine

Skin-Sparing Mastectomy and Immediate Autologous Breast Reconstruction in Locally Advanced Breast Cancer Patients: A UBC Perspective

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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