BREAST RECONSTRUCTION TIMING, OVERALL AND RECURRENCE-FREE SURVIVAL RATES IN PATIENTS WITH BREAST CANCER AFTER MASTECTOMY AND RADIATION THERAPY dashaulrikh@mail.ru

 

BREAST RECONSTRUCTION TIMING, OVERALL AND RECURRENCE-FREE SURVIVAL RATES IN PATIENTS WITH BREAST CANCER AFTER MASTECTOMY AND RADIATION THERAPY

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Diana Enaldieva DIANAENALDIEVA932@gmail.com FSBI National Medicine Research Center of Oncology named after N.N. Petrov of MoH of Russia, Russia, Saint Petersburg Saint Petersburg Russia

Elena Zhiltsova ziltsova@yandex.ru FSBI National Medicine Research Center of Oncology named after N.N. Petrov of MoH of Russia, Russia, Saint Petersburg Saint Petersburg Russia

Tengiz Tabagua tedo8308@mail.ru FSBI National Medicine Research Center of Oncology named after N.N. Petrov of MoH of Russia, Russia, Saint Petersburg Saint Petersburg Russia

Valeriy Levchenko levch.ve@gmail.com FSBI National Medicine Research Center of Oncology named after N.N. Petrov of MoH of Russia, Russia, Saint Petersburg Saint Petersburg Russia

Russia

Poster Exhibition only

Breast reconstruction after mastectomy must consider surgical complications, adverse effects of cancer treatments (radiation or systemic therapy) and patient status. Postoperative complications may delay adjuvant therapy, potentially worsening prognosis due to its impact on recurrence-free and overall survival. Currently, no clear consensus exists on the optimal reconstruction approach for patients requiring adjuvant radiotherapy.

This retrospective analysis evaluated 466 patients with breast cancer treated between 2016 and 2021 at the N.N. Petrov NMRC of Oncology. Patients were stratified into three reconstruction groups: immediate (n=158), immediate-delayed (n=210), and delayed (n=98). Features of the surgical intervention, neoadjuvant and/or adjuvant systemic therapy were analyzed to determine the association with the risk of developing complication.

The median follow-up was 39.0 months. In patients undergoing combined treatment (mastectomy with adjuvant radiotherapy), recurrence-free survival rates were 83.9% in the immediate reconstruction group, 76.8% in the immediate-delayed reconstruction group, and 87.4% in the delayed reconstruction group (p=0.080). Overall survival rates were 97.8%, 95.2%, and 98.8%, respectively (p=0.20). The incidence of reconstructive failures did not significantly depend on the timing of surgery after radiotherapy (p>0.05). However, delayed reconstruction performed more than 6 months post-radiotherapy significantly reduced the rate of capsular contractures (p=0.004).

The combined treatment approach incorporating mastectomy and adjuvant radiotherapy demonstrates high efficacy across all reconstructive surgery modalities in terms of both recurrence-free and overall survival rates in patients. When determining optimal timing for delayed-stage reconstruction following radiotherapy, postponement of expander placement to a longer interval is recommended to reduce the incidence of capsular contracture formation.