Plastic Surgery Research Council
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RECONSTRUCTION AFTER MASTECTOMY FOR BREAST CANCER IS ASSOCIATED WITH IMPROVED SURVIVAL: AN UPDATE ON A SINGLE INSTITUTION STUDY
Presenter: Jennifer L Baker, MD
Co-Authors: Mailey BA; Tokin CA; Blair SL; Wallace AM
University of California San Diego UCSD

Introduction: Reconstruction after mastectomy has positive influences on patient psychological and social well-being. Recent population-based studies suggest an association between postmastectomy reconstruction and an improved breast cancer- specific survival; further research is necessary to investigate the nature of this relationship.

Objective: To determine the overall survival (OS) and disease free survival (DFS) in reconstructed vs. non-reconstructed patients after mastectomy at a single institution.

Methods: Charts from all consecutive breast cancer patients treated with mastectomy between 2003-2011 were reviewed. Patient data including demographic, histo-pathologic, and oncologic specific variables were obtained. OS and DSF were compared between reconstructed and non-reconstructed patients using the log-rank test and Kaplan-Meyer survival curves. A multivariate model to control for demographic and oncologic factors was performed.

Results: Of 615 women treated during our study period, 73.8% (N=464) underwent reconstruction. Reconstructed patients had higher OS and DFS (8.8 vs. 7.4 years, p<0.001; and 8.5 vs. 7.2 years, respectively, p<0.001). After controlling for age, race, marital status, payer category, triple negative status, stage of disease and receipt of chemotherapy, radiation therapy and hormone therapy, reconstructed patients still maintained a survival advantage over non-reconstructed patients [HR 0.34, CI 0.19 0.59, p<0.001]

Conclusion: Patients undergoing breast reconstruction after mastectomy have longer OS and DFS compared to non-reconstructed patients. This finding was conserved in all ages and cancer stages. Explanations for this finding may include improved psycho-social well-being, or a possible unknown biological promotion or anti-carcinogenic effect conferred by reconstruction.


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