Oncologic Outcome of Immediate Breast Reconstruction Following Mastectomy in Patients With Ipsilateral Breast Tumor Recurrence.

PURPOSE: The prevalence of immediate breast reconstruction (IBR) after mastectomy in patients with breast cancer is increasing. However, the applicability of IBR in cases of ipsilateral breast tumor recurrence (IBTR) remains limited. This study evaluated the oncological outcomes of total mastectomy (TM) alone and TM followed by IBR in patients with IBTR. METHODS: This retrospective analysis encompassed patients with IBTR who underwent TM, with or without subsequent IBR, between 2008 and 2018. The exclusion criteria were a third recurrence, delayed reconstruction, chest wall invasion, distant metastasis, supraclavicular or internal mammary lymph node metastasis, or bilateral breast cancer. The cohort was categorized into two groups: TM-only and TM with IBR. RESULTS: In total, 123 patients were included in this study (TM-only: n = 48, TM with IBR: n = 75). The median follow-up period were 52 and 51 months, respectively (p = 0.560). The clinicopathological characteristics were similar, except that advanced pathologic T stage at initial surgery was found more frequently in the TM-only group (p = 0.028). Locoregional recurrence, distant metastasis, and mortality rates were not significantly different between the groups (p = 0.535, p = 0.223, and p = 0.163, respectively). However, the TM with IBR group showed a significantly better overall survival (p = 0.040), but a higher rate of complications (p = 0.011). CONCLUSION: Our results suggest that IBR after TM is a feasible treatment option for patients with IBTR from a prognostic perspective. Nonetheless, the selection of suitable candidates is crucial, considering the observed increase in complications and potential biases inherent in this study.