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RELAPSES AFTER RADICAL SUBCUTANEOUS/SKIN-SPARING MASTECTOMY WITH SIMULTANEOUS RECONSTRUCTION IN BREAST CANCER

https://doi.org/10.17709/2409-2231-2019-6-1-3

Abstract

Objective. To evaluate 3‑year disease-free survival in patients with breast cancer who underwent radical subcutane­ous/skin-sparing mastectomy with simultaneous reconstruction.

Patients and methods. The article analyzes 472 patients diagnosed with breast cancer who underwent radical subcuta­neous/skin-sparing mastectomy in combined or complex treatment. In the Department of Oncology and reconstructive plastic surgery of the breast and skin radical skin mastectomy was performed in 255 (54.1%) and 217 (45.9%) patients with radical subcutaneous mastectomy. Reconstruction was carried out by autotissues, expanders, followed by replace­ment with endoprostheses, as well as a combination of flaps and endoprostheses. The mean age of patients was 43.8 ± 2.2 (18–73) years. In 32.3% of cases patients were in the age group up to 40 years.

Results. In 9 (1,7 ± 0,6%) of patients diagnosed with a recurrence of breast cancer, herewith in 5 cases of local and in 4 cases of regional recurrence (metastases in the infraclavicular lymph nodes).

Treatment of recurrences of breast cancer was as follows: in two cases polychemotherapy courses were conducted, in 6 cases operations were performed — excision of relapse in the breast (3) and subclavian lymphadenectomy (1), remov­al of the reconstructed gland (2), in 1 case — radiation therapy.

In 13% relapses of breast cancer were diagnosed at stage III of breast cancer, the lowest percentage of relapse 0.7% at stage III. In luminal type A recurrence of breast cancer was diagnosed in 1.8%, in luminal B in 2.4%, in triple negative type — 2.5%, in luminal B Her2 positive — 2.7%. Metastases of breast cancer in our group of patients were diagnosed in 22 (4.7 ± 0.9%) patients. The highest percentage of long-term metastasis in our study revealed — 12.5% at stage III, the lowest percentage of 2.8 at stage I breast cancer. 3‑year overall survival of breast cancer patients in our group was 97.8% (n = 269).

Conclusion. Radical subcutaneous/skin-sparing mastectomies with simultaneous reconstruction are radical in the onco­logical plan of treatment and improve the quality of life in patients with breast cancer.

About the Authors

A. D. Zikiryakhodzhayev
P.Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Centre, I.M.Sechenov First Moscow State Medical University (Sechenov University), Peoples’ Friendship University of Russia (RUDN University)
Russian Federation

MD, PhD, DSc, professor of the department of oncology and radiology, head of the department of oncology and reconstructive surgery of the mammary gland and skin

3, 2nd Botkinskiy proezd, Moscow 125284, Russian Federation

8/2 Trubetskaya str., Moscow 119991, Russian Federation

6 Miklukho-Maklaya str., Moscow 117198, Russian Federation



E. A. Rasskazova
P.Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological Centre
Russian Federation

MD, PhD, researcher of the department of oncology and reconstructive surgery of the mammary gland and skin

3, 2nd Botkinskiy proezd, Moscow 125284, Russian Federation



A. Yu. Tukmakov
I.M.Sechenov First Moscow State Medical University (Sechenov University)
Russian Federation

postgraduate

8/2 Trubetskaya str., Moscow 119991, Russian Federation



I. M. Shirokikh
Peoples’ Friendship University of Russia (RUDN University)
Russian Federation

postgraduate of the department of oncology and radiology

6 Miklukho-Maklaya str., Moscow 117198, Russian Federation



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For citations:


Zikiryakhodzhayev A.D., Rasskazova E.A., Tukmakov A.Yu., Shirokikh I.M. RELAPSES AFTER RADICAL SUBCUTANEOUS/SKIN-SPARING MASTECTOMY WITH SIMULTANEOUS RECONSTRUCTION IN BREAST CANCER. Research and Practical Medicine Journal. 2019;6(1):33-40. (In Russ.) https://doi.org/10.17709/2409-2231-2019-6-1-3

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ISSN 2410-1893 (Online)