Purpose: To elucidate whether there is a delay of adjuvant treatment
or detection of recurrences, or an increasing of the recurrence of tumorsin
clinically advanced breast cancer patients. Methods: The study group
included 55 patients underwent mastectomy with immediate reconstruction
(IBR), and 563 patients who received the mastectomy without reconstruction
(non-IBR), and who were stage IIB and IIIA breast cancer patients, at Asan
Medical Center between Jun 1993 and December 2000. We retrospectively
assessed the comparative outcomes through using follow-up data.
Results: Out of 2,057 patients who had undergone the mastectomy on
during the period, 175(8.5%) underwent immediate reconstruction. 55 of them
(31.6%) were stage IIB and IIIA patients, a similar portion(29.9%) was seen
in the 563 patients of same stages without reconstruction. The mean ages of
these groups were 37.1 and 46.9 years, that is, the reconstruction group was
about 10 years younger. All these patients voluntarily underwent immediate
reconstruction. For the patients who were followed up, the local recurrence
was 3.6%(2/55) for the IBR group and 5.2% 29/563) for the non-IBR group. On
the other hand, the distant relapse rates were 12.7% and 13.9%. The
administration of adjuvant chemotherapy was not delayed and radiotherapy was
used as an adjuvant treatment after reconstruction in nine of the
cases(16.4%). Chemotherapy was also conducted in 98.2% of the IBR group and
77.3% of the non-IBR group. While radiotherapy was used in the IBR group
less frequently, there was no statistical difference between the two groups
(P=0.63). Conclusion: Immediate reconstruction following mastectomy
for the treatment of breast cancer is now more frequently performed. IBR can
be done in clinically advanced breast cancer without increasing the risk of
treatment failure or modification.
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