Esthetic reconstruction after mastectomy for inflammatory breast cancer: Is it worthwhile?

Philip L. Chin, James S. Andersen, George Somlo, David Z J Chu, Roderich E. Schwarz, Joshua D I Ellenhorn

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Background: Because inflammatory breast cancer (IBC) has been viewed as a malignancy with a poor likelihood of longterm survival, few women have been offered esthetic reconstruction after mastectomy for IBC. Recent advances in multimodality therapy have improved the outcomes for women with this disease. The purpose of this review was to assess the results of esthetic breast reconstruction in the population with IBC. Study Design: Review of medical records at the City of Hope National Medical Center for the 10-year period ending in May 1997, revealed 23 women who underwent elective esthetic breast reconstruction after mastectomy for IBC. The records of these patients were reviewed retrospectively. Patients requiring reconstruction for large surgical chest wall defects were not included in the review. Results: Treatment for IBC included mastectomy in all patients, Chemotherapy in 22, and chest wall radiation therapy in 14. Immediate reconstruction was performed at the time of mastectomy (n = 14) or was delayed (n = 9). The types of reconstruction included transverse rectus abdominis musculocutaneous flap (n = 18), latissimus dorsi flap (n = 2), or prosthetic mammary implant reconstruction (n = 3). Seven women chose to undergo additional reconstruction procedures (ie, nipple reconstruction) after their initial reconstruction. With a median followup of 44 months for survivors, 16 patients developed recurrence after reconstruction. Of these, 6 were local recurrences and 10 were distant failures. Seven patients are currently alive with no evidence of disease, 4 are currently alive with disease, and 12 have died as a result of breast cancer. The median disease-free survival after reconstruction was 19 months. The median overall survival after reconstruction for all patients was 22 months. The only negative predictor of survival was a positive surgical margin at mastectomy. Conclusions: The significant emotional and esthetic benefits of breast reconstruction should be available to women with IBC. In light of the improving prognosis of IBC with current aggressive multimodality treatment, reconstructive procedures should be offered as part of comprehensive therapy. (C) 2000 by the American College of Surgeons.

Original languageEnglish (US)
Pages (from-to)304-309
Number of pages6
JournalJournal of the American College of Surgeons
Volume190
Issue number3
DOIs
StatePublished - Mar 2000

Fingerprint

Inflammatory Breast Neoplasms
Mastectomy
Esthetics
Mammaplasty
Thoracic Wall
Survival
Breast Implants
Recurrence
Rectus Abdominis
Myocutaneous Flap
Superficial Back Muscles
Nipples
Therapeutics
Disease-Free Survival
Medical Records
Survivors
Radiotherapy
Breast Neoplasms
Drug Therapy

ASJC Scopus subject areas

  • Surgery

Cite this

Chin, P. L., Andersen, J. S., Somlo, G., Chu, D. Z. J., Schwarz, R. E., & Ellenhorn, J. D. I. (2000). Esthetic reconstruction after mastectomy for inflammatory breast cancer: Is it worthwhile? Journal of the American College of Surgeons, 190(3), 304-309. https://doi.org/10.1016/S1072-7515(99)00267-7

Esthetic reconstruction after mastectomy for inflammatory breast cancer : Is it worthwhile? / Chin, Philip L.; Andersen, James S.; Somlo, George; Chu, David Z J; Schwarz, Roderich E.; Ellenhorn, Joshua D I.

In: Journal of the American College of Surgeons, Vol. 190, No. 3, 03.2000, p. 304-309.

Research output: Contribution to journalArticle

Chin, Philip L. ; Andersen, James S. ; Somlo, George ; Chu, David Z J ; Schwarz, Roderich E. ; Ellenhorn, Joshua D I. / Esthetic reconstruction after mastectomy for inflammatory breast cancer : Is it worthwhile?. In: Journal of the American College of Surgeons. 2000 ; Vol. 190, No. 3. pp. 304-309.
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abstract = "Background: Because inflammatory breast cancer (IBC) has been viewed as a malignancy with a poor likelihood of longterm survival, few women have been offered esthetic reconstruction after mastectomy for IBC. Recent advances in multimodality therapy have improved the outcomes for women with this disease. The purpose of this review was to assess the results of esthetic breast reconstruction in the population with IBC. Study Design: Review of medical records at the City of Hope National Medical Center for the 10-year period ending in May 1997, revealed 23 women who underwent elective esthetic breast reconstruction after mastectomy for IBC. The records of these patients were reviewed retrospectively. Patients requiring reconstruction for large surgical chest wall defects were not included in the review. Results: Treatment for IBC included mastectomy in all patients, Chemotherapy in 22, and chest wall radiation therapy in 14. Immediate reconstruction was performed at the time of mastectomy (n = 14) or was delayed (n = 9). The types of reconstruction included transverse rectus abdominis musculocutaneous flap (n = 18), latissimus dorsi flap (n = 2), or prosthetic mammary implant reconstruction (n = 3). Seven women chose to undergo additional reconstruction procedures (ie, nipple reconstruction) after their initial reconstruction. With a median followup of 44 months for survivors, 16 patients developed recurrence after reconstruction. Of these, 6 were local recurrences and 10 were distant failures. Seven patients are currently alive with no evidence of disease, 4 are currently alive with disease, and 12 have died as a result of breast cancer. The median disease-free survival after reconstruction was 19 months. The median overall survival after reconstruction for all patients was 22 months. The only negative predictor of survival was a positive surgical margin at mastectomy. Conclusions: The significant emotional and esthetic benefits of breast reconstruction should be available to women with IBC. In light of the improving prognosis of IBC with current aggressive multimodality treatment, reconstructive procedures should be offered as part of comprehensive therapy. (C) 2000 by the American College of Surgeons.",
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