To examine the clinico-pathological and oncological outcomes of patients who underwent mastectomy following ipsilateral therapeutic mammoplasty
Association of Breast Surgery ePoster Library. To N. 05/15/17; 166344; P141
Natalie To
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Abstract
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Introduction
Patients with therapeutic mammoplasty (TM) may require further surgery for residual disease (involved margins) or recurrence. We aim to evaluate the pathological and technical, as well as oncological outcomes of patients who required a mastectomy having previously had ipsilateral TM.
Methods
A retrospective record review identified patients who had mastectomy after ipsilateral TM between 2005 and 2016. We recorded information including age, reasons for mastectomy, tumour characteristics, margin involvement, re-excision and adjuvant treatment.
Results
Of 1270 who had TM, 66 patients required post-TM mastectomy. They formed 3 groups: 43 (65%) patients with involved margins, 16 (24%) with disease recurrence and 7 for other reasons BRCA carrier. Ten (23%) patients with involved margins had re-excision prior to mastectomy. Reconstruction was carried out on 28 (65%) patients with involved margins of whom 21 (75%) were immediate, whereas all 12 (75%) patients had immediate reconstruction for recurrence. A minority (14%) underwent implant based reconstruction. Qualitative analysis suggests that mastectomy and reconstruction planning was influenced by previous TM incisions. 36 patients (83%) with involved margins were in remission from their disease, compared to only 10 patients (62.5%) in the recurrence group, the most common cause of death in both groups being metastatic breast cancer.
Conclusion
We found that the majority of patients who had post-TM mastectomy for positive margins, did so without re-excision of margins. A large proportion of patients in both groups had immediate reconstruction, permitting non-standard mastectomy following TM.
Patients with therapeutic mammoplasty (TM) may require further surgery for residual disease (involved margins) or recurrence. We aim to evaluate the pathological and technical, as well as oncological outcomes of patients who required a mastectomy having previously had ipsilateral TM.
Methods
A retrospective record review identified patients who had mastectomy after ipsilateral TM between 2005 and 2016. We recorded information including age, reasons for mastectomy, tumour characteristics, margin involvement, re-excision and adjuvant treatment.
Results
Of 1270 who had TM, 66 patients required post-TM mastectomy. They formed 3 groups: 43 (65%) patients with involved margins, 16 (24%) with disease recurrence and 7 for other reasons BRCA carrier. Ten (23%) patients with involved margins had re-excision prior to mastectomy. Reconstruction was carried out on 28 (65%) patients with involved margins of whom 21 (75%) were immediate, whereas all 12 (75%) patients had immediate reconstruction for recurrence. A minority (14%) underwent implant based reconstruction. Qualitative analysis suggests that mastectomy and reconstruction planning was influenced by previous TM incisions. 36 patients (83%) with involved margins were in remission from their disease, compared to only 10 patients (62.5%) in the recurrence group, the most common cause of death in both groups being metastatic breast cancer.
Conclusion
We found that the majority of patients who had post-TM mastectomy for positive margins, did so without re-excision of margins. A large proportion of patients in both groups had immediate reconstruction, permitting non-standard mastectomy following TM.
Introduction
Patients with therapeutic mammoplasty (TM) may require further surgery for residual disease (involved margins) or recurrence. We aim to evaluate the pathological and technical, as well as oncological outcomes of patients who required a mastectomy having previously had ipsilateral TM.
Methods
A retrospective record review identified patients who had mastectomy after ipsilateral TM between 2005 and 2016. We recorded information including age, reasons for mastectomy, tumour characteristics, margin involvement, re-excision and adjuvant treatment.
Results
Of 1270 who had TM, 66 patients required post-TM mastectomy. They formed 3 groups: 43 (65%) patients with involved margins, 16 (24%) with disease recurrence and 7 for other reasons BRCA carrier. Ten (23%) patients with involved margins had re-excision prior to mastectomy. Reconstruction was carried out on 28 (65%) patients with involved margins of whom 21 (75%) were immediate, whereas all 12 (75%) patients had immediate reconstruction for recurrence. A minority (14%) underwent implant based reconstruction. Qualitative analysis suggests that mastectomy and reconstruction planning was influenced by previous TM incisions. 36 patients (83%) with involved margins were in remission from their disease, compared to only 10 patients (62.5%) in the recurrence group, the most common cause of death in both groups being metastatic breast cancer.
Conclusion
We found that the majority of patients who had post-TM mastectomy for positive margins, did so without re-excision of margins. A large proportion of patients in both groups had immediate reconstruction, permitting non-standard mastectomy following TM.
Patients with therapeutic mammoplasty (TM) may require further surgery for residual disease (involved margins) or recurrence. We aim to evaluate the pathological and technical, as well as oncological outcomes of patients who required a mastectomy having previously had ipsilateral TM.
Methods
A retrospective record review identified patients who had mastectomy after ipsilateral TM between 2005 and 2016. We recorded information including age, reasons for mastectomy, tumour characteristics, margin involvement, re-excision and adjuvant treatment.
Results
Of 1270 who had TM, 66 patients required post-TM mastectomy. They formed 3 groups: 43 (65%) patients with involved margins, 16 (24%) with disease recurrence and 7 for other reasons BRCA carrier. Ten (23%) patients with involved margins had re-excision prior to mastectomy. Reconstruction was carried out on 28 (65%) patients with involved margins of whom 21 (75%) were immediate, whereas all 12 (75%) patients had immediate reconstruction for recurrence. A minority (14%) underwent implant based reconstruction. Qualitative analysis suggests that mastectomy and reconstruction planning was influenced by previous TM incisions. 36 patients (83%) with involved margins were in remission from their disease, compared to only 10 patients (62.5%) in the recurrence group, the most common cause of death in both groups being metastatic breast cancer.
Conclusion
We found that the majority of patients who had post-TM mastectomy for positive margins, did so without re-excision of margins. A large proportion of patients in both groups had immediate reconstruction, permitting non-standard mastectomy following TM.
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