Buscar en
Cirugía Española (English Edition)
Toda la web
Inicio Cirugía Española (English Edition) Direct-to-implant breast reconstruction after neoadjuvant chemotherapy: a safe o...
Journal Information
Vol. 97. Issue 10.
Pages 575-581 (December 2019)
Share
Share
Download PDF
More article options
ePub
Visits
194
Vol. 97. Issue 10.
Pages 575-581 (December 2019)
Original article
DOI: 10.1016/j.cireng.2019.11.019
Direct-to-implant breast reconstruction after neoadjuvant chemotherapy: a safe option?
Reconstrucción inmediata mediante implante directo tras quimioterapia neoadyuvante. ¿Es una práctica segura?
Visits
...
Marta Allué Cabañuza,
Corresponding author
martitaallue@hotmail.com

Corresponding author.
, Maria Dolores Arribas del Amoa, Ismael Gil Romeaa, María Pilar Val-Carreres Riveraa, Ramón Sousa Domíngueza, Antonio Tomás Güemes Sáncheza,b
a Unidad de Mama, Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain
b Universidad de Zaragoza, Zaragoza, Spain
Article information
Abstract
Full Text
Bibliography
Download PDF
Statistics
Figures (2)
Tables (5)
Table 1. Demographic Variables and Comorbidities of Patients and Clinical-pathological Tumor Data.
Table 2. MBRI Indications.
Table 3. Surgical Technique and Complications During the First Month Post-op.
Table 4. Oncological Results.
Table 5. Uni- and Multivariate Analysis for Recurrence.
Show moreShow less
Abstract
Introduction

Immediate reconstruction (IBR) after mastectomy in patients who have received neoadjuvant chemotherapy (NACT) remains controversial. The aim of this study is to analyze and compare oncological results as well as complication and reoperation rates in patients undergoing NACT and a control group.

Methods

Retrospective observational case-control study of patients with breast cancer who underwent bilateral mastectomy and direct-to-implant IBR (BMIBR) from 2000-2016. The group that received NACT was matched 1:5 to patients without NACT (Control group).

We evaluated differences between groups using the Chi-squared or Fisher test (qualitative variables), Mann-Whitney U or Student’s t-test (quantitative variables). The survival analysis was performed using Kaplan-Meier curves and log-rank test (SPSS 22.0).

Results

The study included a total of 171 patients with BMIBR: 62 patients (36.3%) after NACT and 109 patients (63.7%) in the control group without NACT. Median follow-up was 52.0 (IQR: 23.0–94.0) months.

In both groups, the indication for BMIBR was patient choice (32.7%). There were no statistically significant differences between groups in terms of complication rate (24.2% in the NACT group and 19.3% in the control group [P = .44]), but differences in oncological results were found.

Patients in the NACT Group had three times more risk of recurrence at a given time than patients in the control group (3.009 [1.349–6.713]) according to the univariate analysis.

Conclusion

Direct-to-implant IBR after skin-sparing mastectomy is a viable option for breast cancer patients undergoing neoadjuvant chemotherapy.

Keywords:
Bilateral mastectomy
Immediate reconstruction
Direct-to-implant
Neoadjuvant chemotherapy
Complications
Reoperation
Resumen
Introducción

La reconstrucción inmediata (RMI) tras mastectomía en pacientes que han recibido quimioterapia neoadyuvante (QTNA) sigue siendo controvertida. El objetivo de este estudio es analizar y comparar resultados oncológicos y las tasas de complicaciones y reintervención en pacientes sometidas a QTNA y un grupo control.

Métodos

Análisis observacional retrospectivo de casos-controles. Pacientes con cáncer de mama intervenidas de MBRMI mediante prótesis directa durante el periodo 2000-2016. Grupo que recibió QTNA emparejadas máximo 1:5 a las pacientes sin QTNA (Grupo control).

Evaluamos diferencias entre grupos mediante test Chi 2 o Fisher (variables cualitativas), U de Mann Whitney o T Student (variables cuantitativas).Análisis de supervivencia mediante curvas de Kaplan–Meier y test de log-rank.SPSS 22.0.

Resultados

Un total de 171 pacientes con MBRMI, 62 pacientes (363%) tras QTNA y 109 pacientes (63.7%) en grupo control sin QTNA. Mediana de seguimiento de 52,0 (RIQ:23,0-94,0)meses.

La indicación para practicar una MBRMI más frecuente en ambos grupos es la elección de la paciente (32.7%).No hubo diferencias estadísticamente significativas entre los grupos en cuanto a tasa de complicaciones [24.2% en el grupo QTNA y 19.3% en grupo control (P = 0,44)].

Sí existen diferencias en resultados oncológicos. Las pacientes del Grupo QTNA tienen tres veces más riesgo que las pacientes del grupo control de presentar recidiva en un momento determinado del tiempo 3,009 (1,349-6,713) según análisis univariante.

Conclusiones

La RMI mediante prótesis directa tras mastectomías ahorradoras de piel es una opción viable de tratamiento para pacientes con cáncer de mama sometidas a quimioterapia neoadyuvante.

Palabras clave:
Mastectomía bilateral
Reconstrucción inmediata
Implante directo
Quimioterapia neoadyuvante
Complicaciones
Reintervención

Article

These are the options to access the full texts of the publication Cirugía Española (English Edition)
Subscriber
Subscriber

If you already have your login data, please click here .

If you have forgotten your password you can you can recover it by clicking here and selecting the option “I have forgotten my password”
Subscribe
Subscribe to

Cirugía Española (English Edition)

Comprar
Comprar acceso al artículo

Comprando el artículo el PDF del mismo podrá ser descargado

Precio 19,34 €

Comprar ahora
Contact
Phone for subscriptions and reporting of errors
From Monday to Friday from 9 a.m. to 6 p.m. (GMT + 1) except for the months of July and August which will be from 9 a.m. to 3 p.m.
Calls from Spain
932 415 960
Calls from outside Spain
+34 932 415 960
E-mail
Article options
Tools
es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos

es en pt
Política de cookies Cookies policy Política de cookies
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here. Utilizamos cookies próprios e de terceiros para melhorar nossos serviços e mostrar publicidade relacionada às suas preferências, analisando seus hábitos de navegação. Se continuar a navegar, consideramos que aceita o seu uso. Você pode alterar a configuração ou obter mais informações aqui.