Triple negative breast cancer and reconstruction: Predictors of recurrence, complications, and mortality

Article type: Research Article

Authors: Sogunro, Olutayo^a; | Sayyed, Adaah A.^{b; c} | Aminpour, Nathan^c | Towfighi, Parhom^c | Maini, Mansi^c | Masanam, Monika^a | Deldar, Romina^b | Murray, Allison^a | De La Cruz, Lucy^a | Greenwalt, Ian^a | Son, Jennifer D.^a

Affiliations: [a] Department of Surgery, MedStar Georgetown University Hospital, Washington, DC, USA | [b] Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington, DC, USA | [c] Georgetown University School of Medicine, Washington, DC, USA

Correspondence: [*] Corresponding author: Olutayo Sogunro, DO, MS, Department of Surgery, Ourisman Breast Center, MedStar Georgetown University Hospital, 3800 Reservoir Road Northwest, Ground Floor, Lombardi Building, Washington, DC 20007, USA. Tel.: +1 (202) 444 3315; E-mail: olutayosogunro@yahoo.com, sogunrobreastsurgery@gmail.com

Abstract: BACKGROUND:Only 42% of all breast cancer patients undergoing mastectomy elect for breast reconstruction. OBJECTIVE:We evaluate factors impacting complications, recurrence, and mortality in triple-negative breast cancer (TNBC) patients undergoing reconstruction. METHODS:Reconstructive TNBC patients at a single institution from 2010 to 2020 were retrospectively reviewed. Patient demographics, cancer characteristics, reconstruction choice, and complications were collected. Statistical significance was defined at p < 0.05. RESULTS:A total of 131 patients were identified. Average age was 47.8 years, 50.4% were Caucasian and 36.4% were African American. Most patients had invasive ductal carcinoma (90.8%), and most underwent nipple-sparing (41.2%) or skin-sparing (38.9%) mastectomies. Twenty-one patients (16.0%) experienced postoperative complications. Patients with complications tended to be older (52.1 versus 46.9 years, p = 0.052). At mean follow-up of 52.1 months, 14.5% experienced cancer recurrence and 5.3% died. Deceased patients were significantly younger at diagnosis (42.2 versus 48.5 years, p = 0.008) and had a lower BMI compared to surviving patients (21.2 versus 26.9 kg/m2; p = 0.014). Patients younger than age 45 years had higher Ki-67 than those older than 45 years (80.0% versus 60.0%, p = 0.013). Outcomes in autologous- versus implant-based reconstruction were not significantly different. CONCLUSIONS:In TNBC post-mastectomy reconstruction patients, age and BMI were predictors of mortality while race, smoking history, reconstruction choice, or type of implant-based reconstruction had no significant effect on these outcomes. SYNOPSIS:The purpose of this study is to evaluate factors that impact complications, recurrence, and mortality in triple negative breast cancer (TNBC) patients undergoing reconstruction. We identified BMI, neoadjuvant chemotherapy, and age as predictors of complications, recurrence, and mortality in TNBC.

Keywords: Triple negative breast cancer, post-mastectomy reconstruction, recurrence, complications, mortality, autologous-based reconstruction, implant-based reconstruction

DOI: 10.3233/BD-220005

Journal: Breast Disease, vol. 41, no. 1, pp. 343-350, 2022