Comparing the recurrence rates of breast cancer after immediate or delayed breast reconstruction.

This study evaluated the rates of local, regional, and distant recurrence between patients who received immediate or delayed autologous deep inferior epigastric perforators (DIEP) flap breast reconstruction (BR). The data showed that there is an increased risk for breast cancer (BC) recurrence in women who received a delayed BR compared to those who received an Immediate BR.

BC is one of the most common cancers found in women globally. The treatment option for breast cancer (BC) usually includes surgery. This can involve the total removal of the breast (mastectomy) or breast-conserving surgery (BCS). BCS involves the removal of the tumor only, with the preservation of the breast. Breast reconstruction (BR) is a key part of BC treatment in women who need a mastectomy. It can increase the quality of life and improve the sexual and social well-being of the patient.

A DIEP flap BR after mastectomy has been increasingly in demand in BC patients. It allows the transfer of the patient’s own tissue (skin, fat, blood vessels) from the lower belly on the patient’s body to form a breast shape. This reconstruction can be either performed immediately at the same time as the mastectomy (IBR; immediate BR) or after a delayed time (DBR; delayed BR). IBR results in a better aesthetic outcome and less psychological distress. DBR can impact the quality of life of patients and involves more visits to the hospital and increased costs. However, the rates of local, regional, and distant recurrence between patients who received immediate or delayed DIEP flap BR have not been investigated.

This study involved 862 patients with BC. A total of 919 DIEP-fap reconstructions were done in these women. 326 patients received 347 IBRs and 536 patients received 572 DBRs. The average follow-up time was 46 months for the IBR group and 86 months for the DBR group.

The local BC recurrence rate (cancer coming back to the same area as the original cancer) was 1.5% for the IBR group versus 1.7% for the DBR group. Patients who received DBR were 2.89 times more likely to experience local recurrence than those patients who received IBR.

The regional BC recurrence rate (cancer coming back to the nearby lymph nodes) was 3.7% for the IBR group compared to 2.4% for the DBR group. When more factors were taken into consideration, this was not considered statistically significant.

The distant BC recurrence rate (cancer spread to distant parts of the body) was 2.8% for the IBR group compared to 6.9% for the DBR group. Patients who received DBR were 5.24 times more likely to experience distant recurrence than those patients who received IBR.

The average time patients in the IBR group had a recurrence was 32.5 months compared to 26.5 months in the DBR group.

This study concluded that there might be an increased risk for BC recurrence in women who receive a DBR compared to those who receive an IBR.

This study looked back in time at medical records and was conducted at 2 institutions in the Netherlands. Larger studies are needed to confirm these results.