■高达42%的乳腺癌患者接受乳房切除术后重建,然而,重建技术尚未在三阴性乳腺癌(TNBC)患者中得到广泛研究.重建并发症可能会延迟辅助治疗;在TNBC中,这本身就增加了局部复发的风险,这可能会极大地影响肿瘤学结果.因此,我们评估了影响TNBC患者乳房切除术后重建技术选择的因素,并评估了手术和肿瘤安全性结局.
■单机构回顾性图表审查确定了在2010年至2020年间接受乳房切除术后重建的TNBC患者。收集的临床特征包括人口统计学,癌症史,重建技术[自体重建(ABR)与基于植入物的重建(IBR)]和手术和肿瘤学结果,如并发症,复发,和死亡率。评估了影响患者是否接受ABR和IBR的因素,以及两个程序之间结果的差异。统计学显著性定义为P<0.05。
■在10年期间,所有乳房切除术后TNBC患者(n=240)的52.9%(n=127)接受了乳房再造,最常见的乳房切除术后立即(97.0%)。与ABR相比,大多数患者接受IBR(82.4%vs.14.5%)。接受ABR的患者年龄大于IBR患者(54.3vs.46.4岁;P=0.040),体重指数较高(BMI;30.0vs.26.1kg/m2;P=0.007)。如果患者有乳腺癌病史,他们更经常追求ABR(36.8%vs.16.7%;P=0.041)或经历了TNBC复发(26.3%vs.9.3%;P=0.034),而原发性TNBC患者更常选择IBR。重建类型不影响并发症(ABR31.6%vs.IBR16.8%,P=0.131),复发率(ABR15.8%vs.IBR13.0%,P=0.719),或死亡率(ABR0.0%vs.IBR6.5%,P=0.593)率。
■年龄等因素,BMI,乳腺癌病史影响了TNBC女性重建技术的选择。并发症没有差异,复发,或死亡发生在这些高风险的患者,无论重建技术,强调ABR和IBR在乳房切除术后TNBC患者的手术和肿瘤学安全性方面均不优越。
UNASSIGNED: Up to 42% of all breast cancer patients undergo post-mastectomy reconstruction, however reconstructive techniques have not been widely studied in patients with triple negative breast cancer (TNBC). Reconstructive complications may delay adjuvant treatments; in TNBC, which inherently carries an increased risk of locoregional recurrence, this can greatly affect oncological outcomes. Therefore, we evaluate factors influencing choice of reconstructive techniques following mastectomy in TNBC patients and assess operative and oncologic safety outcomes.
UNASSIGNED: A single institution retrospective chart review identified TNBC patients who underwent post-mastectomy reconstruction between 2010 to 2020. Clinical characteristics collected included demographics, cancer history, reconstructive techniques [autologous-based reconstruction (ABR) vs. implant-based reconstruction (IBR)] and surgical and oncologic outcomes such as complications, recurrence, and mortality. Factors impacting whether patients underwent ABR versus IBR were assessed, as well as differences in outcomes between the two procedures. Statistical significance was defined as P<0.05.
UNASSIGNED: During the 10-year period, 52.9% (n=127) of all post-mastectomy TNBC patients (n=240) underwent breast reconstruction, most frequently immediately after mastectomy (97.0%). Most patients underwent IBR compared to ABR (82.4% vs. 14.5%). Patients undergoing ABR were older than IBR patients (54.3 vs. 46.4 years; P=0.040) and had a higher body mass index (BMI; 30.0 vs. 26.1 kg/m2; P=0.007). Patients more often pursued ABR if they had a prior breast cancer history (36.8% vs. 16.7%; P=0.041) or experienced TNBC recurrence (26.3% vs. 9.3%; P=0.034), while primary TNBC patients more often opted for IBR. Reconstructive type did not impact complications (ABR 31.6% vs. IBR 16.8%, P=0.131), recurrence (ABR 15.8% vs. IBR 13.0%, P=0.719), or mortality (ABR 0.0% vs. IBR 6.5%, P=0.593) rates.
UNASSIGNED: Factors such as age, BMI, and breast cancer history impacted choice of reconstructive technique among TNBC women. No differences in complications, recurrence, or mortality occur in these high-risk patients regardless of reconstructive technique, highlighting that neither ABR nor IBR is superior in regard to surgical and oncologic safety in post-mastectomy TNBC patients.