Outcome of Immediate Breast Reconstruction in Patients with Nonendocrine-Responsive Breast Cancer : A Monoinstitutional Case-Control Study

The outcome of patients with estrogen receptor (ER)-negative breast cancer who undergo immediate breast reconstruction (IBR) after mastectomy has not been fully investigated. In the present large retrospective casecontrol study, in ER-negative breast cancer patients who received mastectomy, IBR was associated with a better survival trend and a lower rate of local recurrence. Extensive surgical manipulation does not affect prognosis in ER-negative patients. Background: The long-term prognostic relevance of immediate breast reconstruction (IBR) for patients with estrogen receptor (ER)-negative breast cancer (BC) has not been fully elucidated. Patients and Methods: The study population included 444 patients with ER-negative BC who underwent total mastectomy with complete axillary dissection between 1995 and 2006, 339 patients with and 105 patients without IBR. The median follow-up was 8.6 years. Results: Patients treated with IBR were younger (P < .001) and received surgery more recently (2003-2006: 53.1% vs. 39%; P ¼ .0003), and had a lower number of metastatic lymph nodes (>4 lymph nodes involvement: 29.5% vs. 45.7%; P ¼ .0026), smaller tumors (pT1/2: 15% vs. 26.7%; P ¼ .0007), and lower extent of peritumoral vascular invasion (15.9% vs. 21%; P ¼ .032). The 5-year cumulative incidence of locoregional recurrence was 7.1% in the IBR group and 11.7% in the no IBR group (hazard ratio [HR], 0.81; P ¼ .63). The 5-year cumulative incidence of distant metastases were similar in the 2 groups (P ¼ .79). The 5-year overall and disease-free survival proportions were 79.9% versus 69.5% (HR, 1.11; P ¼ .67) and 66.6% versus 54.1% (HR, 1.04; P ¼ .83) in the IBR group and no IBR group, respectively. Conclusion: IBR intervention does not significantly affect prognosis of ER-negative BC patients.