European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology · 2025
Effectiveness of post-mastectomy radiation therapy after breast reconstruction for patients with high-risk breast cancer: A retrospective multicenter cohort study (Reborn study-03).
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Tsuji Wakako, Sasada Shinsuke, Watanabe Noriyuki, Tomita Shoichi, Shimo Ayaka, Uehiro Natsue, Tsukioki Takahiro, Nagura Naomi, Nogi Hiroko, Yamaguchi Kei, Yamagami Kazuhiko, Ogiya Akiko, Suetsugu Hiromi, Nakamura Yuki, Isaka Hirotsugu, Shiraishi Tomohiro, Nishida Yutaka, Yamauchi Chikako, Seki Hirohito, Collaborative Study Group of Scientific Research of the Japan Oncoplastic Breast Surgery Society
Аннотация
INTRODUCTION: Post-mastectomy radiation therapy (PMRT) is a standard treatment modality for patients with high-risk breast cancer. Although it is performed in patients who undergo breast reconstruction (BR), PMRT efficacy following BR in patients with high-risk breast cancer remains unclear. We evaluated the effectiveness of PMRT in patients with high-risk breast cancer who underwent BR.
MATERIALS AND METHODS: This 15-institution retrospective cohort study included patients with high-risk breast cancer who underwent immediate or delayed BR after mastectomy between 2008 and 2018. High-risk patients were defined as those with positive axillary lymph nodes, clinical tumor size of >5 cm, chest wall invasion, or skin invasion.
RESULTS: Of the 1138 included patients, 427 (37.5 %) received PMRT, whereas 711 (62.5 %) did not. The median age at surgery was 46 (range 23-76) years, and the median follow-up period was 8 years. Overall, 149 (34.9 %) and 81 (11.4 %) patients in the PMRT and non-PMRT cohorts, respectively, met >2 high-risk criteria. Breast implant-based reconstruction was performed in 63.0 % and 67.5 % of patients in the PMRT and non-PMRT cohorts, respectively. The 8-year median locoregional recurrence (LRR) rates were significantly lower in the PMRT cohort (5.6 %) than in the non-PMRT cohort (13.3 %) (p < 0.001). PMRT was an independent predictive factor for LRR (hazard ratio: 0.238, 95 % confidence interval: 0.127-0.446, p < 0.001).
CONCLUSION: PMRT following BR for patients with high-risk breast cancer was associated with significantly lower LRR rates, indicating its effectiveness for improving survival in this population.
MATERIALS AND METHODS: This 15-institution retrospective cohort study included patients with high-risk breast cancer who underwent immediate or delayed BR after mastectomy between 2008 and 2018. High-risk patients were defined as those with positive axillary lymph nodes, clinical tumor size of >5 cm, chest wall invasion, or skin invasion.
RESULTS: Of the 1138 included patients, 427 (37.5 %) received PMRT, whereas 711 (62.5 %) did not. The median age at surgery was 46 (range 23-76) years, and the median follow-up period was 8 years. Overall, 149 (34.9 %) and 81 (11.4 %) patients in the PMRT and non-PMRT cohorts, respectively, met >2 high-risk criteria. Breast implant-based reconstruction was performed in 63.0 % and 67.5 % of patients in the PMRT and non-PMRT cohorts, respectively. The 8-year median locoregional recurrence (LRR) rates were significantly lower in the PMRT cohort (5.6 %) than in the non-PMRT cohort (13.3 %) (p < 0.001). PMRT was an independent predictive factor for LRR (hazard ratio: 0.238, 95 % confidence interval: 0.127-0.446, p < 0.001).
CONCLUSION: PMRT following BR for patients with high-risk breast cancer was associated with significantly lower LRR rates, indicating its effectiveness for improving survival in this population.