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Title: The Impact of Skin-Sparing Mastectomy With Immediate Reconstruction in Patients With Stage III Breast Cancer Treated With Neoadjuvant Chemotherapy and Postmastectomy Radiation

Abstract

Purpose: The safety and efficacy of skin-sparing mastectomy (SSM) with immediate reconstruction (IR) in patients with locally advanced breast cancer are unclear. The purpose of this study is to compare the outcomes of women with noninflammatory Stage III SSM with IR vs. non-SSM-treated women who underwent neoadjuvant chemotherapy and adjuvant radiation therapy (XRT). Methods and Materials: Between October 1997 and March 2010, 100 consecutive patients (40 SSM with IR vs. 60 non-SSM) with Stage III breast cancer received anthracycline- and/or taxane-based neoadjuvant chemotherapy, mastectomy, and adjuvant XRT. Clinical stage (SSM with IR vs. for non-SSM) was IIIA (75% vs. 67%), IIIB (8% vs. 18%), and IIIC (8% vs. 8%). Tumors greater than 5 cm were found in 74% vs. 69%; 97% of patients in both groups were clinically node positive; and 8% vs. 18% had T4b disease. Results: The time from initial biopsy to XRT was prolonged for SSM-IR patients (274 vs. 254 days, p = 0.04), and there was a trend toward XRT delay of more than 8 weeks (52% vs. 31%, p = 0.07) after surgery. The rate of complications requiring surgical intervention was higher in the SSM-IR group (37.5% vs. 5%, p < 0.001). The 2-year actuarialmore » locoregional control, breast cancer-specific survival, and overall survival rates for SSM with IR vs. non-SSM were 94.7% vs. 97.4%, 91.5% vs. 86.3%, and 87.4% vs. 84.8%, respectively (p = not significant). Conclusions: In our small study with limited follow-up, SSM with IR prolonged overall cancer treatment time and trended toward delaying XRT but did not impair oncologic outcomes. Complication rates were significantly higher in this group. Longer follow-up is needed.« less

Authors:
;  [1];  [2]; ; ;  [3];  [2];  [1];  [2]; ;  [3];  [2];  [1];  [2]
  1. Department of Radiation Oncology, Emory University, Atlanta, GA (United States)
  2. (United States)
  3. Winship Cancer Institute, Emory University, Atlanta, GA (United States)
Publication Date:
OSTI Identifier:
22056152
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics
Additional Journal Information:
Journal Volume: 82; Journal Issue: 4; Other Information: Copyright (c) 2012 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; Country of input: International Atomic Energy Agency (IAEA); Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BIOPSY; CHEMOTHERAPY; MAMMARY GLANDS; NEOPLASMS; PATIENTS; RADIOTHERAPY; SAFETY; SKIN; SURGERY; WOMEN

Citation Formats

Prabhu, Roshan, Godette, Karen, Winship Cancer Institute, Emory University, Atlanta, GA, Carlson, Grant, Losken, Albert, Gabram, Sheryl, Department of Surgery, Emory University, Atlanta, GA, Fasola, Carolina, Winship Cancer Institute, Emory University, Atlanta, GA, O'Regan, Ruth, Zelnak, Amelia, Department of Hematology and Medical Oncology, Emory University, Atlanta, GA, Torres, Mylin, E-mail: matorre@emory.edu, and Winship Cancer Institute, Emory University, Atlanta, GA. The Impact of Skin-Sparing Mastectomy With Immediate Reconstruction in Patients With Stage III Breast Cancer Treated With Neoadjuvant Chemotherapy and Postmastectomy Radiation. United States: N. p., 2012. Web. doi:10.1016/J.IJROBP.2011.09.024.
Prabhu, Roshan, Godette, Karen, Winship Cancer Institute, Emory University, Atlanta, GA, Carlson, Grant, Losken, Albert, Gabram, Sheryl, Department of Surgery, Emory University, Atlanta, GA, Fasola, Carolina, Winship Cancer Institute, Emory University, Atlanta, GA, O'Regan, Ruth, Zelnak, Amelia, Department of Hematology and Medical Oncology, Emory University, Atlanta, GA, Torres, Mylin, E-mail: matorre@emory.edu, & Winship Cancer Institute, Emory University, Atlanta, GA. The Impact of Skin-Sparing Mastectomy With Immediate Reconstruction in Patients With Stage III Breast Cancer Treated With Neoadjuvant Chemotherapy and Postmastectomy Radiation. United States. doi:10.1016/J.IJROBP.2011.09.024.
Prabhu, Roshan, Godette, Karen, Winship Cancer Institute, Emory University, Atlanta, GA, Carlson, Grant, Losken, Albert, Gabram, Sheryl, Department of Surgery, Emory University, Atlanta, GA, Fasola, Carolina, Winship Cancer Institute, Emory University, Atlanta, GA, O'Regan, Ruth, Zelnak, Amelia, Department of Hematology and Medical Oncology, Emory University, Atlanta, GA, Torres, Mylin, E-mail: matorre@emory.edu, and Winship Cancer Institute, Emory University, Atlanta, GA. Thu . "The Impact of Skin-Sparing Mastectomy With Immediate Reconstruction in Patients With Stage III Breast Cancer Treated With Neoadjuvant Chemotherapy and Postmastectomy Radiation". United States. doi:10.1016/J.IJROBP.2011.09.024.
@article{osti_22056152,
title = {The Impact of Skin-Sparing Mastectomy With Immediate Reconstruction in Patients With Stage III Breast Cancer Treated With Neoadjuvant Chemotherapy and Postmastectomy Radiation},
author = {Prabhu, Roshan and Godette, Karen and Winship Cancer Institute, Emory University, Atlanta, GA and Carlson, Grant and Losken, Albert and Gabram, Sheryl and Department of Surgery, Emory University, Atlanta, GA and Fasola, Carolina and Winship Cancer Institute, Emory University, Atlanta, GA and O'Regan, Ruth and Zelnak, Amelia and Department of Hematology and Medical Oncology, Emory University, Atlanta, GA and Torres, Mylin, E-mail: matorre@emory.edu and Winship Cancer Institute, Emory University, Atlanta, GA},
abstractNote = {Purpose: The safety and efficacy of skin-sparing mastectomy (SSM) with immediate reconstruction (IR) in patients with locally advanced breast cancer are unclear. The purpose of this study is to compare the outcomes of women with noninflammatory Stage III SSM with IR vs. non-SSM-treated women who underwent neoadjuvant chemotherapy and adjuvant radiation therapy (XRT). Methods and Materials: Between October 1997 and March 2010, 100 consecutive patients (40 SSM with IR vs. 60 non-SSM) with Stage III breast cancer received anthracycline- and/or taxane-based neoadjuvant chemotherapy, mastectomy, and adjuvant XRT. Clinical stage (SSM with IR vs. for non-SSM) was IIIA (75% vs. 67%), IIIB (8% vs. 18%), and IIIC (8% vs. 8%). Tumors greater than 5 cm were found in 74% vs. 69%; 97% of patients in both groups were clinically node positive; and 8% vs. 18% had T4b disease. Results: The time from initial biopsy to XRT was prolonged for SSM-IR patients (274 vs. 254 days, p = 0.04), and there was a trend toward XRT delay of more than 8 weeks (52% vs. 31%, p = 0.07) after surgery. The rate of complications requiring surgical intervention was higher in the SSM-IR group (37.5% vs. 5%, p < 0.001). The 2-year actuarial locoregional control, breast cancer-specific survival, and overall survival rates for SSM with IR vs. non-SSM were 94.7% vs. 97.4%, 91.5% vs. 86.3%, and 87.4% vs. 84.8%, respectively (p = not significant). Conclusions: In our small study with limited follow-up, SSM with IR prolonged overall cancer treatment time and trended toward delaying XRT but did not impair oncologic outcomes. Complication rates were significantly higher in this group. Longer follow-up is needed.},
doi = {10.1016/J.IJROBP.2011.09.024},
journal = {International Journal of Radiation Oncology, Biology and Physics},
issn = {0360-3016},
number = 4,
volume = 82,
place = {United States},
year = {2012},
month = {3}
}