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Local recurrence following mastectomy and autologous breast reconstruction: incidence, risk factors, and management

Authors Wu S, Mo M, Wang Y, Zhang N, Li J, Di G, Shao Z, Wu J, Liu G

Received 27 March 2016

Accepted for publication 7 August 2016

Published 4 November 2016 Volume 2016:9 Pages 6829—6834

DOI https://doi.org/10.2147/OTT.S109356

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Professor Min Li


Siyu Wu,1,2 Miao Mo,3 Yujie Wang,1,2 Na Zhang,1,2 Jianwei Li,1,2 Genhong Di,1,2 Zhimin Shao,1,2 Jiong Wu,1,2 Guangyu Liu1,2

1Department of Breast Surgery, Key Laboratory of Breast Cancer in Shanghai, Fudan University Shanghai Cancer Center, 2Department of Oncology, Shanghai Medical College, Fudan University, 3Clinical Statistics Center, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China

Background: Breast reconstruction (BR), including autologous breast reconstruction (ABR) after mastectomy (MST), has been gaining popularity all around the world, especially in the People’s Republic of China during the past decade. However, there is a small proportion, but a significant number, of patients who develop local recurrence (LR) of breast cancer postoperatively. The purpose of this study is to examine the incidence of LR, discuss risk factors associated with LR, and management of LR following MST and ABR.
Methods: A total of 397 patients who underwent MST and ABR after diagnosis of breast cancer were included in this retrospective study. Data were analyzed by the Kaplan–Meier method, the log-rank statistical test, and Cox proportional hazards model.
Results: From January 1999 to December 2011, 400 ABRs were performed in 397 patients in Fudan University Shanghai Cancer Center. The median follow-up time in the study was 3.6 years. LR occurred in 11 of 397 patients, with a median time to LR of 2.9 years. In univariate and multivariate analyses, tumor stage, hormonal therapy (yes or no), and tumor type (multifocal or nonmultifocal) were significantly associated with LR after ABR following MST.
Conclusion: ABR is an oncologically safe surgical procedure with an acceptable LR rate of 2.8%. Risk factors associated with high rate of LR were higher tumor stage, absence of hormonal therapy, and multifocal tumor type.

Keywords: local recurrence, autologous breast reconstruction, incidence, risk factors, management

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