[Influence of immediate breast reconstruction after mastectomy on postoperative survival].

Abstract

Objective: To compare over survival(OS),recurrence free survival(RFS) of 5 years and survival quality between patients with immediate breast reconstruction and patients without breast reconstruction after mastectomy.

Methods: From January 2009 to December 2010,156 patients were diagnosed as breast cancer. Among them,56 patients, aged 30-55 years old, were treated with mastectomy and immediate breast reconstruction as rec onstruction group.100 patients, aged 30-55 years old, were treated with mastectomy without breast reconstruction as control group. The last follow-up time was June 2015.Patients' age, pathological type, clinical stage, lymph node metastasis were analyzed retrospectively. RFS and OS of 5 years and survival was compared by Kaplan Meier method. Survival quality of 1 year and 2 years after operation was compared between them.

Results: Pathologic classification, clinical staging, sentinel lymph node positive rate, axillary lymph node positive rate and triple negative breast cancer had no difference between two groups(P ＞0.05).The median follow-up time was 56.3±13.7 (23-78) and 57.9 ± 14.1(27-78) months in the reconstruction group and control group respectively at end of the June of 2015.RFS 5 years was 75.2％ and 63.3％ respectively in the reconstruction group and control group, showing significant difference between them (P < 0.05).OS 5 years was 81.7％ and 83.3％ respectively in the reconstruction group and control group, with no statistical difference (P ＞ 0.05).Five aspects of physiological status, social/family status, emotion, functional status,additional focus in the reconstruction group 1 year postoperative were higher than those in control group (P ＜ 0.05).Physiology, social/family situation, emotion, functional status of the reconstruction group 2 years after operation were higher than that in control group (P ＜ 0.05).Scores of physiologic al status, social/family status, emotion, functional status and addition of 2 years in the reconstruction group were higher than those in 1 year after operation, with significant difference (P ＜ 0.05).The score improvement in control group was not obvious.

Conclusions: Immediate breast reconstruction after mastectomy of breast improve the survival quality and postoperative RFS, but has no obvious effect on overall survival.