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
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
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
Russian Federation
postgraduate
8/2 Trubetskaya str., Moscow 119991, Russian Federation
I. M. Shirokikh
Peoples’ Friendship University of Russia (RUDN University)
Russian Federation
Russian Federation
postgraduate of the department of oncology and radiology
6 Miklukho-Maklaya str., Moscow 117198, Russian Federation
References
1. Kaprin AD, Starinskii VV, Petrova GV. Sostoyanie onkologicheskoi pomoshchi naseleniyu Rossii v 2017 godu [The state of cancer care in Russia in 2017]. Мoscow, 2018, 236 p. Available at: http://oncology-association.ru/files/medstat/sostoyanie_2017.pdf (In Russian).
2. Zakharkov L. I. Subcutaneous radical mastectomy with primary reconstruction in the treatment of patients with breast cancer. Diss. Мoscow, 2006, 113 p. (In Russian).
3. Malygin SE, Malygin EN, Peterson SB, Protasov AV, Benevsky AI. Local and Regional Recurrences after Mastectomy with Immediate Reconstruction in Breast Cancer Patients. Bulletin of RSMU. 2013;4:24–27. (In Russian).
4. D’Alonzo M, Martincich L, Biglia N, Pisacane A, Maggiorotto F, Rosa GD, et al. Clinical and radiological predictors of nipple-areola complex involvement in breast cancer patients. Eur J Cancer. 2012 Oct;48 (15):2311–8. DOI: 10.1016/j.ejca.2012.04.017
5. Billar JA, Dueck AC, Gray RJ, Wasif N, Pockaj BA. Preoperative predictors of nipple-areola complex involvement for patients undergoing mastectomy for breast cancer. Ann Surg Oncol. 2011 Oct;18 (11):3123–8. DOI: 10.1245/s10434–011–2008–5.
6. Zikiryakhodzhaev AD, Rasskazova EA. Recurrence of breast cancer after subcutaneous mastectomy with simultaneous reconstruction. Research’n Practical Medicine Journal. 2014;1 (1):24–28. (In Russian).
7. Kris MG, Benowitz SI, Adams S. Uspekhi klinicheskoi onkologii 2010: naibolee znachimye dostizheniya v lechenii, profilaktike i skrininge onkologicheskikh zabolevanii. Soobshchenie Amerikanskogo obshchestva klinicheskoi onkologii (ASKO). Zhurnal klinicheskoi onkologii. 2011;5 (1):80–101. (In Russian).
8. Pak DD, Rasskazova TA. Recurrent breast cancer after organ-preserving treatment. Oncosurgery. 2012;4 (2):37–49. (In Russian).
9. Missana MC, Laurent I, Germain M, Lucas S, Barreau L. Long-term oncological results after 400 skin-sparing mastectomies. J Visc Surg. 2013 Nov;150 (5):313–20. DOI: 10.1016/j.jviscsurg.2013.09.011.
10. Merino T, Ip T, Domínguez F, Acevedo F, Medina L, Villaroe A, et al. Risk factors for loco-regional recurrence in breast cancer patients: a retrospective study. Oncotarget. 2018 Jul 13;9 (54):30355–30362. DOI: 10.18632/oncotarget.25735
11. Yi M, Kronowitz SJ, Meric-Bernstam F, Feig BW, Symmans WF, Lucci A, et al. Local, regional, and systemic recurrence rates in patients undergoing skin-sparing mastectomy compared with conventional mastectomy. Cancer. 2011 Mar 1;117 (5):916–24. DOI: 10.1002/cncr.25505.
12. Huang N, Liu М, Chen J, Yang BL, Xue JY, Quan CL, et al. Surgical management of breast cancer in China. A 15 year single-center retrospective study of 18,502 patients. Medicine (Baltimore). 2016 Nov;95 (45): e4201. DOI: 10.1097/MD.0000000000004201
13. Castaneda СА, Rebaza P, Castillo М, Gomez HL, De La Cruz M, Calderon G, et al. Critical review of axillary recurrence in early breast cancer. Crit Rev Oncol Hematol. 2018 Sep;129:146–152. DOI: 10.1016/j.critrevonc.2018.06.013
14. Arvold ND, Taghian AG, Niemierko A, Abi Raad RF, Sreedhara M, Nguyen PL, et al. Age, breast cancer subtype approximation, and local recurrence after breast-conserving therapy. J Clin Oncol. 2011 Oct 10;29 (29):3885–91. DOI: 10.1200/JCO.2011.36.1105.
15. Aalders KC, Bommel AC, Dalen Т, Sonke GS, van Diest PJ, Boersma LJ, et al. Contemporary risks of local and regional recurrence and contralateral breast cancer in patients treated for primary breast cancer. Eur J Cancer. 2016 Aug;63:118–26. DOI: 10.1016/j.ejca.2016.05.010.
Review
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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