JOURNAL DESCRIPTION

The Medical Radiology and Radiation Safety journal ISSN 1024-6177 was founded in January 1956 (before December 30, 1993 it was entitled Medical Radiology, ISSN 0025-8334). In 2018, the journal received Online ISSN: 2618-9615 and was registered as an electronic online publication in Roskomnadzor on March 29, 2018. It publishes original research articles which cover questions of radiobiology, radiation medicine, radiation safety, radiation therapy, nuclear medicine and scientific reviews. In general the journal has more than 30 headings and it is of interest for specialists working in thefields of medicine¸ radiation biology, epidemiology, medical physics and technology. Since July 01, 2008 the journal has been published by State Research Center - Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency. The founder from 1956 to the present time is the Ministry of Health of the Russian Federation, and from 2008 to the present time is the Federal Medical Biological Agency.

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Medical Radiology and Radiation Safety. 2024. Vol. 69. № 4

DOI:10.33266/1024-6177-2024-69-4-81-87

Е.А. Rasskazova 1, A.D. Zikiryakhodzhaev 1-3

Results of Treatment of Patients with Stage I‒Ii Breast Cancer after Subcutaneous/Skin-Preserving Mastectomies with Reconstruction with/without Radiation Therapy

1 P.A. Hertsen Moscow Oncology Research Institute, Moscow, Russia

2 I.M. Sechenov First Moscow State Medical University, Moscow, Russia

3 People’s Friendship University of Russia, Moscow, Russia

Contact person: E.A. Rasskazova, e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

 

Abstract

Purpos: To study the oncological results and features of complications in patients with breast cancer in stages I‒II after subcutaneous/skin-preserving mastectomies with reconstruction with/without radiation therapy.
Material and methods: From 2013 to 2022, 984 breast cancer patients underwent 1020 subcutaneous/skin-preserving mastectomies with simultaneous one- or two-stage reconstruction at the Herzen Moscow Medical Research Institute.
Subcutaneous mastectomy with reconstruction was performed in 617 (60.5 %), skin-preserving mastectomy in 403 (39.5 %) cases.
Reconstruction with the patient’s own tissues was performed in 5.7 %, expanders/implants in 94.3 % of patients.
Results: The recurrence rate of breast cancer was 41 (4.2±0.6 %), the frequency of distant metastases was diagnosed in 53 (5.4±0.7 %) in the studied group of patients.
Complications were diagnosed in 241 (24.5 %) patients.
Recurrence in the group with radiation therapy was 2.6±0.6 (OR 0.98, CI 1.52‒3.48, 95 %), without radiation therapy 5.9 % (OR 2.13, CI 0.92‒5.18, 95 %) regardless of the stage of breast cancer (criterion T > 2, p ˂ 0,05).
Capsular contracture (CC) of the III‒IV degree was diagnosed in 9.4 % of the analyzed group of patients.
Capsular contracture of the III‒IV degree worsens the aesthetic result of breast reconstruction, as well as reduces the quality of life of patients. With simultaneous two–stage reconstruction, the risk of developing CC was 4.2 % (after LT 4.7 %, without LT 3.6 %), with one-stage reconstruction, the risk of developing CC 11.2 % (after LT 15.8 %, without LT 4 %).
In the study group of patients, the effect of LT on the risk of CC was 12.6 %, without LT 3.7 % (p < 0.05), the difference is statistically significant.
In our study, the recurrence of breast cancer at the edge of R1 was 6.8±2.5 %, at R0 – 3±0.6 % (p > 0.05).
When analyzing the age and risk of recurrence, we did not identify an age dependence, before 40 years the probability of recurrence was 4.3±1 %, after 40 years – 3.3±0.7 % (criterion T = 0.44, p > 0.05).
A statistically significant difference in our study was revealed, except for radiation therapy, during NAPHT, thus, in the group with NAPHT, the recurrence was 2.4± 0.8 %, without NAPHT – 4.6±0.7 % (criterion T = 2.16, p ˂ 0.05).
When performing a simultaneous two-stage reconstruction of a patient with the inclusion of radiation therapy (LT), the risk of skin protrusion was 18 %, without radiation therapy – 8.3 %.
Capsular contracture (CC) of the III‒IV degree was diagnosed in 9.4 % of the analyzed group of patients.
Capsular contracture of the III‒IV degree worsens the aesthetic result of breast reconstruction, as well as reduces the quality of life of patients. With simultaneous two–stage reconstruction, the risk of developing CC was 4.2 % (after LT 4.7 %, without LT 3.6 %), with one-stage reconstruction, the risk of developing CC 11.2 % (after LT 15.8 %, without LT 4 %).
In the study group of patients, the effect of LT on the risk of CC was 12.6 %, without LT 3.7 % (p < 0.05), the difference is statistically significant.

Keywords: breast cancer, recurrence, skin-preserving mastectomies, subcutaneous mastectomies, radiation therapy, reconstruction, implants, protrusion, capsular contracture

For citation: Rasskazova ЕА, Zikiryakhodzhaev AD. Results of Treatment of Patients with Stage I‒Ii Breast Cancer after Subcutaneous/Skin-Preserving Mastectomies with Reconstruction with/without Radiation Therapy. Medical Radiology and Radiation Safety. 2024;69(4):81–87. (In Russian). DOI:10.33266/1024-6177-2024-69-4-81-87

 

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 PDF (RUS) Full-text article (in Russian)

 

Conflict of interest. The authors declare no conflict of interest.

Financing. The study had no sponsorship.

Contribution. Rasskszova A.E. ‒ idea and design of the trial; Zikiryakhodzhaev A.D. – reviewing.

Article received: 20.03.2024. Accepted for publication: 25.04.2024.

 

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