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Original Article | Open Access

Comparison of outcomes between immediate implant-based and autologous reconstruction: 15-year, single-center experience in a propensity score-matched Chinese cohort

Shanshan He1, Bowen Ding1, Gang Li2, Yubei Huang3, Chunyong Han1, Jingyan Sun1, Qingfeng Huang1, Jing Liu1, Zhuming Yin1, Shu Wang1, Jian Yin1( )
Department of Breast Reconstruction, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Sino‐Russian Joint Research Center for Oncoplastic Breast Surgery, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin’s Clinical Research Center for Cancer, Tianjin 300060, China
School of Pharmacy, University College London, London WC1N 1AX, UK
Department of Cancer Epidemiology and Biostatistics, Tianjin Medical University Cancer Institute & Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin, Tianjin’s Clinical Research Center for Cancer, Tianjin 300060, China
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Abstract

Objective

The number of immediate breast reconstruction (IBR) procedures has been increasing in China. This study aimed to investigate the oncological safety of IBR, and to compare the survival and surgical outcomes between implant-based and autologous reconstruction.

Methods

Data from patients diagnosed with invasive breast cancer who underwent immediate total breast reconstruction between 2001 and 2016 were retrospectively reviewed. Long-term breast cancer-specific survival (BCSS), disease-free survival (DFS), and locoregional recurrence-free survival (LRFS) were evaluated. Patient satisfaction with the breast was compared between the implant-based and autologous groups. BCSS, DFS, and LRFS were compared between groups after propensity score matching (PSM).

Results

A total of 784 IBR procedures were identified, of which 584 were performed on patients with invasive breast cancer (implant-based, n = 288; autologous, n = 296). With a median follow-up of 71.3 months, the 10-year estimates of BCSS, DFS, and LRFS were 88.9% [95% confidence interval (CI) (85.1%–93.0%)], 79.6% [95% CI (74.7%–84.8%)], and 94.0% [95% CI (90.3%–97.8%)], respectively. A total of 124 patients completed the Breast-Q questionnaire, and no statistically significant differences were noted between groups (P = 0.823). After PSM with 27 variables, no statistically significant differences in BCSS, DFS, and LRFS were found between the implant-based (n = 177) and autologous (n = 177) groups. Further stratification according to staging, histological grade, lymph node status, and lymph-venous invasion status revealed no significant survival differences between groups.

Conclusions

Both immediate implant-based and autologous reconstruction were reasonable choices with similar long-term oncological outcomes and patient-reported satisfaction among patients with invasive breast cancer in China.

Keywords

autologousChineseOncological safetyimmediate breast reconstructionimplant-basedpropensity-score matched

Electronic Supplementary Material

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cbm-19-9-1410_ESM.pdf (549 KB)

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Cancer Biology & Medicine
Volume 19 Issue 9,
September 2022
Pages 1410-1421
DOI: 10.20892/j.issn.2095-3941.2021.0368
Cite this article:
He S, Ding B, Li G, et al. Comparison of outcomes between immediate implant-based and autologous reconstruction: 15-year, single-center experience in a propensity score-matched Chinese cohort. Cancer Biology & Medicine, 2022, 19(9): 1410-1421. https://doi.org/10.20892/j.issn.2095-3941.2021.0368

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Received: 02 August 2021
Accepted: 18 October 2021
Published: 22 September 2022
©2022 Cancer Biology & Medicine.

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