scholarly journals Predictors of delayed breast reconstruction in the Netherlands: a 5-year follow-up study in stage I–III breast cancer patients

Breast Cancer ◽  
2021 ◽  
Author(s):  
L. S. E. van Egdom ◽  
K. M. de Ligt ◽  
L. de Munck ◽  
L. B. Koppert ◽  
M. A. M. Mureau ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
The Netherlands ◽  
Breast Reconstruction ◽  
Cancer Patients ◽  
Hospital Volume ◽  
Stage I ◽  
Regression Analyses ◽  
Breast Cancer Patients ◽  
Delayed Breast Reconstruction

Abstract Purpose Delayed breast reconstruction (DBR) is a valid option for postmastectomy breast cancer patients who have a desire for breast reconstruction but are not considered suitable for immediate breast reconstruction (IBR). The objective of this study was to investigate the clinical practice and predictors of the use of DBR in the Netherlands. Methods Stage I–III breast cancer patients diagnosed from January to March 2012 and treated with mastectomy were selected from the Netherlands Cancer Registry. Routinely collected patient, tumor, treatment and hospital characteristics were complemented with data about DBR up to 2018. Multivariable logistic regression analyses were performed to identify factors independently associated with postmastectomy DBR. Factors associated with time to DBR were identified through Cox regression analyses. Results Of all patients who underwent mastectomy (n = 1,415), 10.2% underwent DBR. DBR patients more often received autologous reconstruction compared to IBR patients (37.5% vs 6.2%, p < 0.001). Age below 50 years (age < 35 OR 15.55, age 35–49 OR 4.18) and neoadjuvant and adjuvant chemotherapy (OR 2.59 and OR 2.83, respectively) were significantly associated with DBR. Mean time to DBR was 2.4 years [range 1–6 years]. Time to DBR was significantly associated with age < 35 years (HR 2.22), and a high hospital volume (HR 1.87). Discussion The use of DBR after mastectomy could not be fully explained by age below 50 years, chemotherapy, and hospital volume. Treatment with radiotherapy and adjuvant chemotherapy increased time to DBR. More information about patient preferences is needed to understand the use and timing of reconstruction.

scholarly journals The role of adjuvant chemotherapy in stage I–III male breast cancer: a SEER-based analysis

2020 ◽  
Vol 12 ◽  
pp. 175883592095835
Author(s):  
Wei-Ping Li ◽  
Hong-Fei Gao ◽  
Fei Ji ◽  
Teng Zhu ◽  
Min-Yi Cheng ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Male Breast Cancer ◽  
Tumour Size ◽  
Male Breast ◽  
Stage I ◽  
Breast Cancer Patients ◽  
Chemotherapy Group

Background and aims: Male breast cancer is an uncommon disease. The benefit of adjuvant chemotherapy in the treatment of male breast cancer patients has not been determined. The aim of this study was to explore the value of adjuvant chemotherapy in men with stage I–III breast cancer, and we hypothesized that some male patients may safely skip adjuvant chemotherapy. Methods: Male breast cancer patients between 2010 and 2015 from the Surveillance Epidemiology and End Results database were included. Univariate and multivariate Cox analyses were used to analyse the factors associated with survival. The propensity score matching method was adopted to balance baseline characteristics. Kaplan–Meier curves were used to evaluate the impacts of adjuvant chemotherapy on survival. The primary endpoint was survival. Results: We enrolled 514 patients for this study, including 257 patients treated with chemotherapy and 257 patients without. There was a significant difference in overall survival (OS) but not in breast cancer-specific survival (BCSS) between the two groups ( p < 0.001 for OS and p = 0.128 for BCSS, respectively). Compared with the non-chemotherapy group, the chemotherapy group had a higher 4-year OS rate (97.5% versus 95.2%, p < 0.001), while 4-year BCSS was similar (98% versus 98.8%, p = 0.128). The chemotherapy group had longer OS than the non-chemotherapy group among HR+, HER2–, tumour size >2 cm, lymph node-positive male breast cancer patients ( p < 0.05). Regardless of tumour size, there were no differences in OS or BCSS between the chemotherapy and non-chemotherapy cohorts for lymph node-negative patients (OS: p > 0.05, BCSS: p > 0.05). Adjuvant chemotherapy showed no significant effects on both OS and BCSS in patients with stage I (OS: p = 0.100, BCSS: p = 0.858) and stage IIA breast cancer (OS: p > 0.05, BCSS: p > 0.05). Conclusion: For stage I and stage IIA patients, adjuvant chemotherapy could not improve OS and BCSS. Therefore, adjuvant chemotherapy might be skipped for stage I and stage IIA male breast cancer patients.

scholarly journals Psychosocial Aspects of Immediate versus Delayed Breast Reconstruction

Breast Care ◽  
2017 ◽  
Vol 12 (6) ◽  
pp. 374-377 ◽  
Author(s):  
Anne-Sophie Heimes ◽  
Kathrin Stewen ◽  
Annette Hasenburg
Keyword(s):  
Breast Cancer ◽  
Breast Reconstruction ◽  
Cancer Patients ◽  
Well Being ◽  
Psychological Outcomes ◽  
Psychosocial Aspects ◽  
Breast Cancer Patients ◽  
Immediate Reconstruction ◽  
Delayed Breast Reconstruction ◽  
Delayed Reconstruction

Background: Only little is known about the psychosocial aspects of breast cancer patients after mastectomy with immediate versus delayed breast reconstruction. Methods: We systematically screened PubMed using the following key words: mastectomy, immediate vs. delayed reconstruction, psychosocial aspects and quality of life. To highlight different psychological outcomes, studies were categorized into those describing: anxiety, depression, body image and satisfaction with the surgical outcome. We also compared patients after mastectomy alone with those undergoing immediate or delayed reconstruction. Results: Methodologies and psychological outcomes varied among the identified studies, making it difficult to compare results. There are contradictory outcomes concerning the psychosocial aspects of breast cancer patients after mastectomy alone compared with those who underwent an immediate or delayed reconstruction following mastectomy. Some studies show that immediate reconstruction after mastectomy had a positive impact on patients' psychological well-being. In contrast, other studies indicated that in the long-term view the compared patient groups were very similar concerning psychosocial aspects. Conclusion: Analyzing different aspects of psychosocial well-being after breast cancer surgery, there might be an advantage in choosing immediate reconstruction, if oncological safety allows it.

Very low-dose adjuvant chemotherapy in steroid receptor negative stage I breast cancer patients

1998 ◽  
Vol 34 (1) ◽  
pp. 66-70 ◽  
Author(s):  
R. Jakesz ◽  
H. Samonigg ◽  
M. Gnant ◽  
E. Kubista ◽  
P. Steindorfer ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Low Dose ◽  
Steroid Receptor ◽  
Stage I ◽  
Breast Cancer Patients

scholarly journals Does chemotherapy or radiotherapy affect the postoperative complication in breast cancer patients who underwent immediate breast reconstruction with tissue expander?

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sung Mi Jung ◽  
Byung-Joon Jeon ◽  
Jinsun Woo ◽  
Jai Min Ryu ◽  
Se Kyung Lee ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Adjuvant Chemotherapy ◽  
Postoperative Complications ◽  
Breast Reconstruction ◽  
Cancer Patients ◽  
Tissue Expander ◽  
Immediate Breast Reconstruction ◽  
Breast Cancer Patients ◽  
The Impact ◽  
To Receive

Abstract Background Immediate breast reconstruction with tissue expander in breast cancer patients who were expected to receive adjuvant therapy, such as chemotherapy or radiotherapy, has been a topic of debate. Postoperative complications from tissue expander procedures can delay the timing of adjuvant treatment and subsequently increase the probability of recurrence. The purpose of this study was to identify the impact of chemotherapy and radiotherapy on postoperative complications in patients who underwent immediate reconstruction (IR) using tissue expander. Methods We conducted a retrospective study of 1081 breast cancer patients who underwent mastectomy and IR using tissue expander insertion between 2012 and 2017 in Samsung Medical Center. The patients were divided into two groups based on complications (complication group vs. no complication group). Complication group was regarded to have surgical removal or conservative treatment based on clinical findings such as infection, capsular contracture, seroma, hematoma, rupture, malposition, tissue viability, or cosmetic problem. The complication group had 59 patients (5.5%) and the no complication group had 1022 patients (94.5%). Results In univariate analysis, adjuvant radiotherapy and adjuvant chemotherapy were significantly associated with postoperative complications. In multivariate analysis, however, only higher pathologic N stage was significantly associated with postoperative complications (p < 0.001). Chemotherapy (p = 0.775) or radiotherapy (p = 0.825) were not risk factors for postoperative complications. Conclusions IR with tissue expander after mastectomy may be a treatment option even when the patients are expected to receive adjuvant chemotherapy or radiotherapy. These results will aid patients who are concerned about the complications of IR caused by chemotherapy or radiotherapy determine whether or not to have IR. Trial registration Patients were selected and registered retrospectively, and medical records were evaluated.

Is there a survival benefit with adjuvant chemotherapy for patients with stage I (T1N0) triple negative breast cancer?

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e11547-e11547
Author(s):  
T. H. Luu ◽  
S. Lau ◽  
R. Nelson ◽  
M. Ottochian ◽  
A. Garcia ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Overall Survival ◽  
Adjuvant Chemotherapy ◽  
Cancer Patients ◽  
Triple Negative Breast Cancer ◽  
Survival Benefit ◽  
Triple Negative ◽  
Stage I ◽  
P Value ◽  
Breast Cancer Patients

e11547 Background: Chemotherapy is the only systemic modality for patients with breast cancer lacking expression of estrogen, progesterone, and HER2 receptors (triple negative), a group comprising 15% of all breast cancers. The majority of such patients present with nodal metastases. The median time to distant recurrence is short: at 2.6 years, and median time to death is 4.2 years. (Dent R, et al. Triple-Negative Breast Cancer: Clinical Features and Patterns of Recurrence, Clin Cancer Res 2007; 13(15) August, 2007). The benefit from proceeding with adjuvant chemotherapy for ≤2cm, node negative triple negative breast cancer remains undefined. Patients and Methods: A retrospective chart review was conducted to assess the benefit of adjuvant chemotherapy for overall survival for stage I (T1N0) triple-negative breast cancer treated from 1996 to 2006 at City of Hope and USC. ER, PR, and HER2 status (as assessed by fluorescent in-situ hybridization (FISH) or immunohistochemistry) were reviewed and confirmed. Overall survival was defined as time from date of diagnosis to date of death. All patients received standard surgery ± radiation. Results: A total of 100 stage I triple-negative breast cancer patients were identified. The median age at diagnosis was 56 (range 27–91). Of the 100 patients, 59 received adjuvant chemotherapy: 38 received anthracycline-based, 17 received non-anthracycline-based regimens and 4 were unknown. Median length of follow-up was 4.0 years. No difference in overall survival was found in patients who received adjuvant chemotherapy (p-value = 0.94). Similarly, there was no difference between patients who received non-anthracycline-based chemotherapy versus those given anthracycline-based chemotherapy (p-value=0.17). The group of patients who received adjuvant chemotherapy were younger (51.8 y.o versus 61.5 y.o (p=0.0004)) and had larger tumor size (13.6mm versus 10.2mm (p=0.0002)). Lack of statistical significance may be related to the limited sample size. Conclusion: We did not find a statistically survival benefit of adjuvant chemotherapy in 100 triple negative stage I breast cancer patients. Further studies are needed to clarify the role of adjuvant chemotherapy in this group of patients. No significant financial relationships to disclose.

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