Refereed journal article or data article (A1)

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




List of Authors: Tamminen Anselm, Meretoja Tuomo, Koskivuo Ilkka

Publisher: ACADEMIC PRESS INC ELSEVIER SCIENCE

Publication year: 2022

Journal: Journal of Surgical Research

Journal name in source: JOURNAL OF SURGICAL RESEARCH

Journal acronym: J SURG RES

Volume number: 279

Number of pages: 8

ISSN: 0022-4804

eISSN: 1095-8673

DOI: http://dx.doi.org/10.1016/j.jss.2022.05.007

URL: https://www.sciencedirect.com/science/article/pii/S0022480422003249

Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/175746911


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.


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Last updated on 2022-17-08 at 15:27