Literature review assessing time to adjuvant chemotherapy and long term oncological outcomes between patients undergoing simple mastectomy and immediate reconstruction
Association of Breast Surgery ePoster Library. Rychlik I. 05/15/17; 166275; P037
Mr. Igor J. Rychlik
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Abstract
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Introduction: Decision making on whether to opt for simple mastectomy or immediate reconstruction for breast cancer can be challenging for patients and clinicians. It is important to inform patients on the incidence of delay to adjuvant treatment and oncological safety. A review of the available evidence was therefore conducted to help clarify these important questions
Methods: A literature search was carried out using PubMed. MeSH terms used were immediate reconstruction, simple mastectomy, complications, recurrence rates, metastatic disease, disease free and overall survival
Results: 80 studies were identified (63 retrospective cohorts, 9 matched cohort, 6 prospective matched cohorts, 2 prospective case series). In total, we analysed 47,821 simple mastectomy and 14,684 immediate reconstruction patients. Tumour characteristics were similar between groups (grade, type, nodal metastasis, ER/HER status). Analysis of outcomes from all studies revealed that comparing simple mastectomy to immediate reconstruction the mean time to chemotherapy (days) was 28.6 (6-119) and 38.2 (14-238) respectively. Percentage of patients who had delay to chemotherapy (>3 months) was 5.4% (0-8.4%) and 6.1% (0-20%). Local recurrence rates were 2.5% and 4.5% at a median follow up time of 49.9 and 54.8 months. 5 year disease free survival was 79.4% and 81.8%. 10 year disease free survival was 64% and 61.2%
Conclusion: Retrospective studies suggest that immediate reconstruction, despite have a wider range of post-operative complications does not result in delay to adjuvant chemotherapy, long term follow up suggests that it is oncologically safe compared to simple mastectomy.
Methods: A literature search was carried out using PubMed. MeSH terms used were immediate reconstruction, simple mastectomy, complications, recurrence rates, metastatic disease, disease free and overall survival
Results: 80 studies were identified (63 retrospective cohorts, 9 matched cohort, 6 prospective matched cohorts, 2 prospective case series). In total, we analysed 47,821 simple mastectomy and 14,684 immediate reconstruction patients. Tumour characteristics were similar between groups (grade, type, nodal metastasis, ER/HER status). Analysis of outcomes from all studies revealed that comparing simple mastectomy to immediate reconstruction the mean time to chemotherapy (days) was 28.6 (6-119) and 38.2 (14-238) respectively. Percentage of patients who had delay to chemotherapy (>3 months) was 5.4% (0-8.4%) and 6.1% (0-20%). Local recurrence rates were 2.5% and 4.5% at a median follow up time of 49.9 and 54.8 months. 5 year disease free survival was 79.4% and 81.8%. 10 year disease free survival was 64% and 61.2%
Conclusion: Retrospective studies suggest that immediate reconstruction, despite have a wider range of post-operative complications does not result in delay to adjuvant chemotherapy, long term follow up suggests that it is oncologically safe compared to simple mastectomy.
Introduction: Decision making on whether to opt for simple mastectomy or immediate reconstruction for breast cancer can be challenging for patients and clinicians. It is important to inform patients on the incidence of delay to adjuvant treatment and oncological safety. A review of the available evidence was therefore conducted to help clarify these important questions
Methods: A literature search was carried out using PubMed. MeSH terms used were immediate reconstruction, simple mastectomy, complications, recurrence rates, metastatic disease, disease free and overall survival
Results: 80 studies were identified (63 retrospective cohorts, 9 matched cohort, 6 prospective matched cohorts, 2 prospective case series). In total, we analysed 47,821 simple mastectomy and 14,684 immediate reconstruction patients. Tumour characteristics were similar between groups (grade, type, nodal metastasis, ER/HER status). Analysis of outcomes from all studies revealed that comparing simple mastectomy to immediate reconstruction the mean time to chemotherapy (days) was 28.6 (6-119) and 38.2 (14-238) respectively. Percentage of patients who had delay to chemotherapy (>3 months) was 5.4% (0-8.4%) and 6.1% (0-20%). Local recurrence rates were 2.5% and 4.5% at a median follow up time of 49.9 and 54.8 months. 5 year disease free survival was 79.4% and 81.8%. 10 year disease free survival was 64% and 61.2%
Conclusion: Retrospective studies suggest that immediate reconstruction, despite have a wider range of post-operative complications does not result in delay to adjuvant chemotherapy, long term follow up suggests that it is oncologically safe compared to simple mastectomy.
Methods: A literature search was carried out using PubMed. MeSH terms used were immediate reconstruction, simple mastectomy, complications, recurrence rates, metastatic disease, disease free and overall survival
Results: 80 studies were identified (63 retrospective cohorts, 9 matched cohort, 6 prospective matched cohorts, 2 prospective case series). In total, we analysed 47,821 simple mastectomy and 14,684 immediate reconstruction patients. Tumour characteristics were similar between groups (grade, type, nodal metastasis, ER/HER status). Analysis of outcomes from all studies revealed that comparing simple mastectomy to immediate reconstruction the mean time to chemotherapy (days) was 28.6 (6-119) and 38.2 (14-238) respectively. Percentage of patients who had delay to chemotherapy (>3 months) was 5.4% (0-8.4%) and 6.1% (0-20%). Local recurrence rates were 2.5% and 4.5% at a median follow up time of 49.9 and 54.8 months. 5 year disease free survival was 79.4% and 81.8%. 10 year disease free survival was 64% and 61.2%
Conclusion: Retrospective studies suggest that immediate reconstruction, despite have a wider range of post-operative complications does not result in delay to adjuvant chemotherapy, long term follow up suggests that it is oncologically safe compared to simple mastectomy.
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