Tolerance of latissimus dorsi in immediate breast reconstruction without implant to radiotherapy

Bérthet, G; Faure, C.; Dammacco, M.-A.; Vermesch, C.; Delay, E.; Quoc, C. Ho; Carrabin, Nicolas

doi:10.1016/j.bjps.2017.08.010

Cited by 14 publications

(12 citation statements)

References 26 publications

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“…Minor revisions and breast height reduction of immediate autologous breast reconstruction in terms of therapeutic methods and tumor stage rates beyond 6 months of radiotherapy(17). However, subjective reports by patients after IABR and PORT are not inferior in comparison with non-irradiated or delayed reconstruction groups(18)(19)(20). Except for one case of major complication, new lesion or continuous progression of abnormal image finding was not observed in our 23 patients with IABR plus radiotherapy.…”

mentioning

confidence: 62%

Long-term outcomes of immediate autologous breast reconstruction after definite adjuvant therapy in intermediate and locally advanced breast cancer

Yoon¹,

Rim²,

Yang³

et al. 2019

Ann Transl Med

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Background: To analyze oncologic outcomes and reconstruction quality in locally advanced stage breast cancer after performing immediate autologous breast reconstruction (IABR).Methods: From 2007 to 2014, data of patients aged ≤70 years old with stage II-III breast cancer who received total mastectomy (TM) were extracted from medical records. Exclusion criteria were: previous contralateral breast cancer, follow-up loss before adjuvant therapy completion, and artificial reconstruction. Patients were divided into two groups: (I) TM alone, and (II) TM + IABR. Overall survival (OS) and locoregional recurrence free survival (LRRFS) were calculated. Times of minor revision, abnormal image findings in breast, and change of breast height were observed. Results: Sixty-one of 188 patients received IABR after TM. Stage IIIB-C was the most important prognostic factor for OS (P<0.001) and LRRFS (P<0.001). For stage II, five-year TM and TM + IABR OS rates were 96.8% and 100% (P=0.324), respectively. For stage IIIB-C, five-year TM and TM + IABR OS rates were 57.6% and 62.5% (P=0.544), respectively. For stage II, five-year TM and TM + IABR LRRFS were 98.1% and 95.7% (P=0.998), respectively. For stage IIIB-C, five-year TM and TM + IABR LRRFS were 70.8% and 62.5% (P=0.378), respectively. Two major complications were observed after IABR. Minor revisions, abnormal image findings, and change of breast height were common without showing significant relation with adjuvant radiotherapy or tumor stage.Conclusions: IABR showed feasible oncologic outcomes in 5-year follow-up. Adjuvant radiotherapy had little effect on quality of reconstruction. However, IABR in advanced stage should be cautiously applied considering expected survival and minor problems after IABR.

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confidence: 62%

Long-term outcomes of immediate autologous breast reconstruction after definite adjuvant therapy in intermediate and locally advanced breast cancer

Yoon¹,

Rim²,

Yang³

et al. 2019

Ann Transl Med

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“…Latissimus dorsi musculo-cutaneous or partial muscle flap has been used for reconstruction in patients with BC for decades [8][9][10][11][12][13][14][15][16][17][18]. It is also an important opportunity to use this muscle for patients with local recurrence after BCS.…”

Section: Discussionmentioning

confidence: 99%

“…The possibility to fill the tumor cavity by using autologous flaps in selected patients increases the breast conservation ratio and enables this intervention to be a serious alternative to subcutaneous mastectomy and implant procedures [13][14][15][16][17][18]. Subcutaneous mastectomy with latissimus dorsi muscle flap usually requires implant and adds additional cost.…”

Section: Introductionmentioning

confidence: 99%

Comparison of breast cancer patients who underwent partial mastectomy (PM) with mini latissimus dorsi flap (MLDF) and subcutaneous mastectomy with implant (M + I) regarding quality of life (QOL), cosmetic outcome and survival rates

et al. 2020

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Purpose: The latissimus dorsi muscle has long been used in breast cancer (BC) patients for reconstruction. This study aimed to compare early stage BC patients who had partial mastectomy (PM) with mini latissimus dorsi flap (MLDF) and subcutaneous mastectomy with implant (MI) with respect to quality of life (QoL), cosmetic outcome (CO), and survival rates. Patients and methods: The data of patients who underwent PM + MLDF (Group 1) and M + I (Group 2) between January 2010 and January 2018 were evaluated. Both groups were compared in terms of demographics, clinical and pathological characteristics, surgical morbidity, survival, quality of life, and cosmetic results. The EORTC-QLQ C30 and EORTC-QLO BR23 questionnaires and the Japanese Breast Cancer Society (JBCS) Cosmetic Evaluation Scale were used to assess the quality of life and the cosmetic outcome, respectively.

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“…The generic reference to ‘breast reconstruction’ was intended to capture all articles addressing the type and timing of breast reconstruction. Two authors independently reviewed abstracts of all studies published between 1985 and 2014, and the full texts of those studies published in 2015–2017. Levels of clinical evidence (LoE) were evaluated for each publication and scored from I to V by employing Oxford criteria.…”

Section: Methodsmentioning

confidence: 99%

International multidisciplinary expert panel consensus on breast reconstruction and radiotherapy

Nava

Benson

Audretsch

et al. 2019

British Journal of Surgery

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Background Conflicting evidence challenges clinical decision‐making when breast reconstruction is considered in the context of radiotherapy. Current literature was evaluated and key statements on topical issues were generated and discussed by an expert panel at the International Oncoplastic Breast Surgery Meeting in Milan 2017. Methods Studies on radiotherapy and breast reconstruction (1985 to September 2017) were screened using MEDLINE, Embase and CENTRAL. The literature review yielded 30 controversial key questions. A set of key statements was derived and the highest levels of clinical evidence (LoE) for each of these were summarized. Nineteen panellists convened for dedicated discussions at the International Oncoplastic Breast Surgery Meeting to express agreement, disagreement or abstention for the generated key statements. Results The literature review identified 1522 peer‐reviewed publications. A list of 22 key statements was produced, with the highest LoE recorded for each statement. These ranged from II to IV, with most statements (11 of 22, 50 per cent) supported by LoE III. There was full consensus for nine (41 per cent) of the 22 key statements, and more than 75 per cent agreement was reached for half (11 of 22). Conclusion Poor evidence exists on which to base patient‐informed consent. Low‐quality studies are conflicting with wide‐ranging treatment options, precluding expert consensus regarding optimal type and timing of breast reconstruction in the context of radiotherapy. There is a need for high‐quality evidence from prospective registries and randomized trials in this field.

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Tolerance of latissimus dorsi in immediate breast reconstruction without implant to radiotherapy

Cited by 14 publications

References 26 publications

Long-term outcomes of immediate autologous breast reconstruction after definite adjuvant therapy in intermediate and locally advanced breast cancer

Long-term outcomes of immediate autologous breast reconstruction after definite adjuvant therapy in intermediate and locally advanced breast cancer

Comparison of breast cancer patients who underwent partial mastectomy (PM) with mini latissimus dorsi flap (MLDF) and subcutaneous mastectomy with implant (M + I) regarding quality of life (QOL), cosmetic outcome and survival rates

International multidisciplinary expert panel consensus on breast reconstruction and radiotherapy

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