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Prognosis of isolated locoregional recurrence after early breast cancer with immediate breast reconstruction surgery: a retrospective multi‑institutional study

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Abstract

Background

The prognosis in patients with breast cancer with isolated locoregional recurrence (ILRR) without simultaneous distant metastases after immediate breast reconstruction (IBR) remains unknown. We aimed to investigate the prognosis in this patient population.

Methods

This multi-institutional retrospective observational study evaluated 3295 patients with primary breast cancer who underwent IBR at 12 Japanese medical facilities between January 1, 2008 and December 31, 2016. The outcome measures were the prognostic factors for ILRR after IBR, 5-year distant metastasis-free interval (DMFI), and 5-year overall survival (OS).

Results

Mastectomy or skin-sparing mastectomy was performed in 3295 patients. ILRR occurred in 70 patients, and the median observation period from ILRR diagnosis was 39.3 months. Of the 70 patients, 9 (12.9%) had axillary lymph node recurrence (ALNR) at the time of ILRR diagnosis. The 5-year DMFI and OS rates after ILRR were 92.4% and 91.2%, respectively. Pathological lymph node metastasis at primary surgery (P = 0.041) and ALNR (P = 0.022) at ILRR were significantly associated with DMFI in the univariate analysis. ALNR was the only independent prognostic factor in the multivariate analysis (P = 0.041). Post-mastectomy radiation therapy (PMRT; P = 0.022) and ALNR (P = 0.043) were significantly associated with OS in the univariate analysis, and both PMRT (P = 0.010) and ALNR (P = 0.028) were independent prognostic factors in the multivariate analysis for OS.

Conclusions

Although patients with breast cancer who had ILRR after IBR have favorable prognosis, ALNR may lead to poor prognosis. To the best of our knowledge, this study is the first to report the prognosis of these patients.

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Data availability

The datasets are not publicly available due to restrictions used under the license for the current study but are available from the corresponding author on reasonable request.

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Acknowledgements

We thank the Scientific Committee of the Japanese Breast Cancer Society. This study was supported by a grant from the Scientific Committee of the Japanese Breast Cancer Society.

Author information

Authors and Affiliations

  1. Department of Breast Surgery, Kyorin University School of Medicine, 6-20-2 Shinkawa, Mitaka-city, Tokyo, 181-8611, Japan

    Hirohito Seki

  2. Department of Breast Surgery, Saitama Medical Center, Saitama, Japan

    Hirohito Seki

  3. Department of Breast Surgery, Japanese Red Cross Medical Center, Tokyo, Japan

    Akiko Ogiya

  4. Department of Breast Surgical Oncology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan

    Akiko Ogiya

  5. Department of Breast Surgical Oncology, St. Luke’s International Hospital, Tokyo, Japan

    Naomi Nagura

  6. Department of Breast and Endocrine Surgery, St. Marianna University School of Medicine, Kanagawa, Japan

    Ayaka Shimo

  7. Department of Breast and Endocrine Surgery, Kawasaki Municipal Tama Hospital, Kanagawa, Japan

    Ayaka Shimo

  8. Department of Breast and Thyroid Surgery, Yokohama City University Medical Center, Yokohama, Kanagawa, Japan

    Kazutaka Narui

  9. Department of Surgical Oncology, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima, Japan

    Shinsuke Sasada

  10. Department of Breast Surgery, Mie University School of Medicine, Mie, Japan

    Makoto Ishitobi

  11. Department of Breast Surgery, Osaka Habikino Medical Center, Osaka, Japan

    Makoto Ishitobi

  12. Department of Breast and Endocrine Surgery, Jikei University School of Medicine, Tokyo, Japan

    Hiroko Nogi

  13. Department of Breast Surgery, Nagoya City University Graduate School of Medical Sciences, Aichi, Japan

    Naoto Kondo

  14. Sakurai Breast Clinic, Wakayama, Japan

    Teruhisa Sakurai

  15. Department of Radiation Oncology, Shiga General Hospital, Shiga, Japan

    Chikako Yamauchi

  16. Department of Plastic and Reconstructive Surgery, Tokyo Medical and Dental University, Tokyo, Japan

    Hiroki Mori

  17. Department of Plastic Surgery, Okayama University Hospital, Okayama, Japan

    Miho Saiga

  18. Department of Breast Oncology, Tokai University School of Medicine, Kanagawa, Japan

    Naoki Niikura

  19. Department of Breast and Endocrine Surgery, Okayama University Hospital, Okayama, Japan

    Tadahiko Shien

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  1. Hirohito Seki
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Consortia

Collaborative Study Group of Scientific Research of the Japanese Breast Cancer Society

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Correspondence to Hirohito Seki.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the respective institutional review boards and was conducted in accordance with the ethical principles of the Declaration of Helsinki.

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Seki, H., Ogiya, A., Nagura, N. et al. Prognosis of isolated locoregional recurrence after early breast cancer with immediate breast reconstruction surgery: a retrospective multi‑institutional study. Breast Cancer (2024). https://doi.org/10.1007/s12282-024-01607-0

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