유방 전절제술 후 즉시 유방 재건술을 시행 받은 유방암 환자의 치료 성적
Clinical Outcome of Immediate Breast Reconstruction after Mastectomy for Breast Cancer
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Purpose: This study aimed to investigate clinical outcomes of breast cancer patients who underwent mastectomy with or without immediate breast reconstruction. Methods: Of 1,847 patients undergoing total mastectomy, 371 (20.1%) underwent immediate reconstruction between January 2005 and December 2011. Clinicopathological characteristics and survival were compared by performing univariate and multivariate analysis. Results: The proportion of reconstruction had been gradually increasing since 2009. Reconstruction group showed younger age at diagnosis and lower cancer stages. Adjuvant chemotherapy and radiation therapy were more frequently administered in the mastectomy alone group. During a median follow-up period of 57 months, locoregional relapse-free survival (LRRFS) was similar regardless of type of surgery. However the reconstruction group showed a more favorable overall survival (OS). Multivariate analysis for LRRFS revealed no statistical significance but the OS was higher in the reconstruction group. In the mastectomy alone group, two-thirds died of breast cancer, while all patients in the reconstruction group died of breast cancer. Stage-matched breast cancer specific survival was similar between both groups. Conclusion: Immediate breast reconstruction is oncologically safe after mastectomy for breast cancer. Considering the quality of life, the patient should be preoperatively counseled by a multidisciplinary team regarding possible immediate reconstruction.
Abstract
Purpose: This study aimed to investigate clinical outcomes of breast cancer patients who underwent mastectomy with or without immediate breast reconstruction. Methods: Of 1,847 patients undergoing total mastectomy, 371 (20.1%) underwent immediate reconstruction between January 2005 and December 2011. Clinicopathological characteristics and survival were compared by performing univariate and multivariate analysis. Results: The proportion of reconstruction had been gradually increasing since 2009. Reconstruction group showed younger age at diagnosis and lower cancer stages. Adjuvant chemotherapy and radiation therapy were more frequently administered in the mastectomy alone group. During a median follow-up period of 57 months, locoregional relapse-free survival (LRRFS) was similar regardless of type of surgery. However the reconstruction group showed a more favorable overall survival (OS). Multivariate analysis for LRRFS revealed no statistical significance but the OS was higher in the reconstruction group. In the mastectomy alone group, two-thirds died of breast cancer, while all patients in the reconstruction group died of breast cancer. Stage-matched breast cancer specific survival was similar between both groups. Conclusion: Immediate breast reconstruction is oncologically safe after mastectomy for breast cancer. Considering the quality of life, the patient should be preoperatively counseled by a multidisciplinary team regarding possible immediate reconstruction.
참고문헌 (16)
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