ABSTRACT
Objective:To compare the therapeutic effects between immediate breast reconstruction (IBR) after skin-sparing mastecto-my and modified radical mastectomy (MRM) in young breast cancer patients (≤35 years), as well as to analyze the prognostic factors of IBR in these patients. Methods:The clinicopathological data of young breast cancer patients who had undergone IBR after skin-spar-ing mastectomy (60 cases) and MRM (68 cases) in Liuzhou People's Hospital from July 2008 to June 2014 were retrospectively ana-lyzed. Local recurrence, disease-free survival, and overall survival of the patients between the two groups were compared. The influ-encing factors for survival of the IBR group patients, such as age, tumor size, and nipple-areolar complex preservation, were analyzed. Results:All patients were followed-up for a period ranging from 15 to 88 months with a median of 51. In the IBR group, local recur-rence, distant metastasis, and death occurred in 3, 8, and 5 cases, respectively. The 3-and 5-year disease-free survival rates (DFSR) were 91.7%and 81.7%, respectively, whereas the overall survival rate (OSR) was 91.7%. In the MRM group, local recurrence, distant metastasis, and death occurred in 2, 9, and 5 cases, respectively. The 3-and 5-year DFSRs were 94.1%and 83.8%, respectively, where-as the OSR was 92.6%. No statistical difference was noted between the two groups (P>0.05). The analysis of prognostic correlation fac-tors in the IBR group patients shows that lymph node metastasis and estrogen and progesterone receptor-negative correlated with the tumor-free survival and overall survival rates (P<0.05). Conclusion:No apparent statistical difference in the comparison of the local re-currence and long-term survival rate was observed between the two groups' young breast cancer patients who underwent IBR after skin-sparing mastectomy and MRM. IBR after skin-sparing mastectomy is safe for young breast cancer patients with early-stage, and nipple-areolar complex preservation does not increase the risk of recurrence in the IBR group patients. Lymph node metastasis and es-trogen and progesterone receptor-negative are the major prognostic factors of IBR after skin-sparing mastectomy in young breast can-cer patients.
ABSTRACT
Objective:To compare the therapeutic effect of immediate breast reconstruction using latissimus dorsi musculocutane-ous flap after modified radical mastectomy with the conventional modified radical surgery of breast cancer. Methods:A retrospec-tive analysis of 224 female patients with Stage 0 to IIIA breast cancer was conducted. The patients were admitted to the Department of Breast Surgery of Liuzhou People's Hospital between November 2009 and July 2012. The cases were divided into two groups accord-ing to different surgical options:immediate breast reconstruction (IBR) and modified radical surgery of the breast (MRSB). After con-trastive analyses of the postoperative complications, cosmetic results, quality of life, local failure rate, distant metastases and mortality rates between the two groups, the therapeutic efficiency of the two surgeries was evaluated. Results:No statistical differences were ob-served in the postoperative complications between the two groups, such as hydrops, skin flap necrosis, limb exercise and shoulder joint motion, drainage time, and starting time of adjuvant therapy (P>0.05). The patients in the IBR group had a better quality of life than those in the MRSB group (P0.05). Conclusion:Compared with the tradi-tional MRSB group, the option of IBR after modified radical mastectomy not only achieves similar therapeutic outcomes but also pres-ents advantages such as better aesthetic effect of the reconstructed breast, easy surgical procedures, high safety, improvement of the breast contour outline, and improved quality of life after operation. Therefore, IBR is a safe and available therapeutic method for pa-tients with early breast cancer.
ABSTRACT
BACKGROUND:How to keep the intact shape of the breast while treating tumor has been widely concerned by more doctors and patients, breast reconstruction is introduced, developed and considered an important part in the treatment of breast tumors. OBJECTIVE:To explore the feasibility and therapeutic effects of immediate breast reconstruction after modified radical mastectomy and latissimus dorsi myocutaneous flap transplantation. METHODS:We retrospectively analyzed the clinical and pathological features of 42 breast cancer patients under immediate breast reconstruction after modified radical mastectomy with latissimus dorsi musculocuraneous flap or extended latissimus dorsi musculocuraneous flap. The procedure duration, postoperative complications and cosmetic outcome were assessed. RESULTS AND CONCLUSION:Among the involved 42 patients, 33 cases underwent modified radical mastectomy, retaining the nipple and areola of breast, 9 cases underwent modified radical mastectomy, retaining the skin of breast, 24 cases underwent breast reconstruction with latissimus dorsi musculocuraneous flap, 18 cases underwent breast reconstruction with extended latissimus dorsi musculocuraneous flap. The skin flap and reconstructed breast al survived, without severe complications. According to objective evaluation results, the cosmetic outcome was good in 39 cases and fair in 3 cases. The subjective evaluation results were good in 40 cases and fair in 2 cases. Al the patients were fol owed up for 9-41 months. One patient had bone metastasis 19 months after operation and there was no case with local recurrence. Immediate breast reconstruction after modified radical mastectomy with latissimus dorsi musculocuraneous flap is a simple and feasible operation process, with optimal effects, high security, and high survival.