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Recurrences and distant metastases after radical subcutaneous and skin-sparing mastectomies with reconstruction for breast cancer

DOI: https://doi.org/10.29296/25877305-2023-10-11

E. Rasskazova(1), Candidate of Medical Sciences; A. Zikiryakhodzhaev(1–3), MD; Professor А. Kaprin(1, 3), Academician of the Russian Academy of Sciences, MD
1-P.A. Herzen Moscow Oncology Research Institute, Branch, National Medical Radiology Research Center, Ministry of Health of Russia
2-I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
3-Peoples’ Friendship University of Russia, Moscow

The paper presents literature data on oncological results (the features of recurrences and metastases) of subcutaneous or skin-sparing mastectomies with reconstruction for breast cancer (BC). Local recurrences of BC, as well as distant metastases occur in about 75% of cases in the first 5 years after surgery. The risk of recurrences and metastases correlates with the molecular biological type of cancer. The paper considers the relationship of postoperative radiation therapy after subcutaneous or skin-sparing mastectomies to the risk of a recurrence. Analyzing the literature data allows conclusions about the low risk of recurrences after skin-sparing/subcutaneous mastectomies with single-stage reconstruction. Local and regional recurrences after these surgical interventions occur if there are poor prognostic factors, including those at Stages IIВ–IIIС of the disease, metastases in the regional lymph nodes, multicentricity, in the absence of radiation therapy, in the presence of HER2 overexpression or triple-negative breast cancer, if the patients are young.

breast cancer
subcutaneous mastectomy
skin-sparing mastectomy
breast reconstruction
radiation therapy.

  1. Зикиряходжаев А.Д., Рассказова Е.А. Рецидивы рака молочной железы после подкожных радикальных мастэктомий с одномоментной реконструкцией. Research and Practical Medicine Journal. 2014; 1 (1): 24–8 [Zikiryakhodzhaev A.D., Rasskazova E.A. Recurrence of breast cancer after subcutaneous mastectomy with simultaneous reconstruction. Research and Practical Medicine Journal. 2014; 1 (1): 24–8 (in Russ.)]. DOI: 10.17709/2409-2231-2014-1-1-24-28
  2. Захарков Л.И. Подкожные радикальные мастэктомии с первичной реконструкцией при лечении больных раком молочной железы. Дисс. … канд. мед. наук. М., 2006; 113 с. [Zakharkov L.I. Podkozhnye radikal'nye mastektomii s pervichnoi rekonstruktsiei pri lechenii bol'nykh rakom molochnoi zhelezy. Diss. … kand. med. nauk. M., 2006; 113 р. (in Russ.)].
  3. Galimberti V., Vicini E., Corso G. Nipple-sparing and skin-sparing mastectomy: Review of aims, oncological safety and contraindications. Breast. 2017; 34 Suppl 1(Suppl 1): S82–S84. DOI: 10.1016/j.breast.2017.06.034
  4. Куклин И.А. Оптимизация хирургического лечения и реабилитации при опухолях молочной железы. Автореф. дисс. ... д-ра мед. наук. Иркутск, 2009; 35 с. [Kuklin I.A. Optimizatsiya khirurgicheskogo lecheniya i reabilitatsii pri opukholyakh molochnoi zhelezy. Avtoref. diss. ... d-ra med. nauk. Irkutsk, 2009; 35 р. (in Russ.)].
  5. Slavin S.A., Schnitt S.J., Duda R.B. et al. Skin-sparing mastectomy and immediate reconstruction: oncologic risk and aesthetic results in patients with early-stage breast cancer. Plast Reconstr Surg. 1998; 102 (1): 49–62. DOI: 10.1097/00006534-199807000-00008
  6. Канаев С.В. Роль лучевой терапии в лечении рака молочной железы. Практическая онкология. 2002; 3 (1): 45–51 [Kanaev S.V. Rol' luchevoi terapii v lechenii raka molochnoi zhelezy. Practical Oncology. 2002; 3 (1): 45–51 (in Russ.)].
  7. Smith B.L., Coopey S.B. Nipple-Sparing Mastectomy. Adv Surg. 2018; 52 (1): 113–26. DOI: 10.1016/j.yasu.2018.03.008
  8. Kris M.G., Benowitz S.I., Adams S. et al. Clinical cancer advances 2010: annual report on progress against cancer from the American Society of Clinical Oncology. J Clin Oncol. 2010; 28 (36): 5327–47. DOI: 10.1200/JCO.2010.33.2742
  9. Малыгин С.Е., Малыгин Е.Н., Петерсон С.Б. и др. Местные и региональные рецидивы после мастэктомии с одномоментной реконструкцией при раке молочной железы. Вестник РГМУ. 2013; 4: 24–7 [Malygin S.E., Malygin E.N., Peterson S.B. et al. Local and regional recurrences after mastectomy with immediate reconstruction in breast cancer patients. Bulletin of RSMU. 2013; 4: 24–7 (in Russ.)].
  10. Merino T., Ip T., Dominguez F. et al. Risk factors for loco-regional recurrence in breast cancer patients: a retrospective study. Oncotarget. 2018; 9: 30355–62. DOI: 10.18632/oncotarget.25735
  11. Missana M.C., Laurent I., Germain M. et al. Long-term oncological results after 400 skin-sparing mastectomies. J Visc Surg. 2013; 150 (5): 313–20. DOI: 10.1016/j.jviscsurg.2013.09.011
  12. Yi M., Kronowitz S.J., Meric-Bernstam F. et al. Local, regional, and systemic recurrence rates in patients undergoing skin-sparing mastectomy compared with conventional mastectomy. Cancer. 2011; 117 (5): 916–24. DOI: 10.1002/cncr.25505
  13. Nakagawa T., Oda G., Mori H. et al. Prognosis of Subcutaneous Mastectomy for Special Types of Breast Cancer. Medicina (Kaunas). 2022; 58 (1): 112. DOI: 10.3390/medicina58010112
  14. Huang N., Liu М., Chen J. Surgical management of breast cancer in China. A 15-year single-center retrospective study of 18,502 patients. Medicine (Baltimore). 2016; 95 (45): e4201. DOI: 10.1097/MD.0000000000004201
  15. Aalders K.C., Bommel A.C., Dalen Т. Contemporary risks of local and regional recurrence and contralateral breast cancer in patients treated for primary breast cancer. Eur J Cancer. 2016; 63: 118–26. DOI: 10.1016/j.ejca.2016.05.010
  16. Chan Y.H.-Y., Yau W.-M., Cheung P.S.-Y. Oncological Safety and Technical Feasibility of Nipple-Sparing Mastectomy for Breast Cancer: The Hong Kong Experience. World J Surg. 2018; 42 (5): 1375–83. DOI: 10.1007/s00268-017-4197-y
  17. Cihan Y.B., Sarigoz T. Role of postmastectomy radiation therapy in breast cancer patients with T1-2 and 1-3 positive lymph nodes. Onco Targets Ther. 2016; 9: 5587–95. DOI: 10.2147/OTT.S106871
  18. Montero A., Ciérvide R., Garcia-Aranda M. et al. Postmastectomy radiation therapy in early breast cancer: Utility or futility? Crit Rev Oncol Hematol. 2020; 147: 102887. DOI: 10.1016/j.critrevonc.2020.102887