Oncological Safety of Skin-Sparing Mastectomy and Immediate Breast Reconstruction in Extensive Ductal Carcinoma In Situ

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http://hdl.handle.net/10138/346398

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Tamminen , A , Meretoja , T & Koskivuo , I 2022 , ' Oncological Safety of Skin-Sparing Mastectomy and Immediate Breast Reconstruction in Extensive Ductal Carcinoma In Situ ' , Journal of Surgical Research , vol. 279 , pp. 25-32 . https://doi.org/10.1016/j.jss.2022.05.007

Title: Oncological Safety of Skin-Sparing Mastectomy and Immediate Breast Reconstruction in Extensive Ductal Carcinoma In Situ
Author: Tamminen, Anselm; Meretoja, Tuomo; Koskivuo, Ilkka
Contributor organization: HUS Comprehensive Cancer Center
Clinicum
University of Helsinki
Department of Oncology
Date: 2022-11
Language: eng
Number of pages: 8
Belongs to series: Journal of Surgical Research
ISSN: 0022-4804
DOI: https://doi.org/10.1016/j.jss.2022.05.007
URI: http://hdl.handle.net/10138/346398
Abstract: Introduction: Skin-sparing mastectomy (SSM) with immediate breast reconstruction is the ideal treatment for interested and suitable patients with extensive ductal carcinoma in situ (DCIS). There is no guideline to indicate on how large DCIS the procedure can be performed safely. The primary target of this study was to define the oncological safety of SSM in extensive pure DCIS. The secondary target was to find predictive factors for DCIS upstaging to invasive disease.Materials and methods: A total of 71 consecutive patients with extensive pure DCIS and undergoing SSM with immediate latissimus dorsi (LD) breast reconstruction were retrospectively evaluated. Results: The median size of DCIS lesion in preoperative imaging was 60 mm, the median weight of mastectomy specimen was 350 g, and the median resection margin (RM) was 2.0 mm. A total of 20 patients (28%) had an RM less than 0.5 mm and nine patients (13%) had ink positive margins. Six patients having positive RM underwent reoperation. A total of 29 patients (41%) presented invasive cancer foci in final histopathological assessment and nine patients (13%) had an axillary metastasis. Adjuvant therapy was given to 23 patients presenting invasive cancer. There were no local recurrences or distant metastases (0%, 95% confidence interval 0-0.051) during the mean follow-up of 71 mo. None of the factors evaluated predicted upstaging to invasive disease.Conclusions: SSM with immediate breast reconstruction in patients with extensive DCIS is oncologically safe even when the margins are close or positive. Additional invasive foci and solitary axillary lymph node metastases are frequent but do not worsen the outcome. (c) 2022 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Subject: Breast reconstruction
Ductal carcinoma in situ
Latissimus dorsi flap
Mastectomy
Recurrence
CORE-NEEDLE-BIOPSY
LOCAL RECURRENCE
FOLLOW-UP
NODE METASTASES
LYMPH-NODES
CANCER
TUMOR
PREDICTORS
INVASION
MARGINS
3126 Surgery, anesthesiology, intensive care, radiology
3122 Cancers
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion


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