Premastectomy radiotherapy (PreMRT) and regional node irradiation (RNI) followed by immediate breast reconstruction (IMBR) is feasible and safe, according to a study published online April 5 in JAMA Network Open.
Mark V. Schaverien, M.D., from University of Texas MD Anderson Cancer Center in Houston, and colleagues assessed the feasibility and safety of PreMRT followed by mastectomy and IMBR in 49 patients with cT0-T3, N0-N3b breast cancer.
The researchers reported that 48 patients underwent mastectomy with IMBR at a median of 23 days after radiotherapy. Techniques included microvascular autologous flap reconstruction (41), latissimus dorsi pedicled flap reconstruction (five), and tissue expander placement (two). No complete autologous flap losses were recorded and one patient underwent tissue expander explantation. In total, eight patients (17 percent) had mastectomy skin flap necrosis of the treated breast, with one patient undergoing reoperation. There were no locoregional recurrences or distant metastasis during a median 29.7 months of follow-up.
“Our trial represents a pioneering achievement in the United States, demonstrating the safety and effectiveness of this paradigm-shifting treatment sequence for patients with breast cancer,” Schaverien said in a statement. “This sequence not only enhances surgical outcomes but also eliminates the need for patients to defer breast reconstruction surgery, significantly enhancing their quality of life.”
Several authors disclosed ties to industry.
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