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Contemporary Trends in Breast Reconstruction Use and Impact on Survival Among Women with Inflammatory Breast Cancer

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Breast reconstruction is generally discouraged in women with inflammatory breast cancer (IBC). Nevertheless, reconstruction rates are increasing in this population.

Objective

We aimed to determine contemporary trends and predictors of breast reconstruction use and its impact on mortality among IBC patients.

Methods

Demographic, clinicopathologic, and follow-up data for women with non-metastatic IBC having mastectomy between 2004 and 2015 were collected from the Surveillance, Epidemiology, and End Results (SEER) 18 registries database. Rates and predictors of immediate breast reconstruction, along with survival outcomes between the breast reconstruction and no reconstruction groups were calculated. To account for selection bias, a propensity score analysis matching one reconstruction patient to three no reconstruction patients was performed.

Results

A total of 4076 women with non-metastatic IBC who underwent mastectomy (388 [9.5%] with breast reconstruction and 3688 [90.5%] without) were included. The proportion of women undergoing breast reconstruction and contralateral prophylactic mastectomy increased from 6.2 to 15.3% and 12.9 to 29.6%, respectively, between 2004 and 2015. Younger age, higher annual income, metropolitan residence, and bilateral mastectomy predicted breast reconstruction use. The 10-year breast cancer-specific survival was 62.9% for women having breast reconstruction and 47.6% for women not having breast reconstruction. After propensity-matched analysis, 10-year cancer-specific survival was similar between the reconstruction (56.6%) and no reconstruction (62.2%) groups (adjusted hazard ratio 0.96, 95% confidence interval 0.79–1.16; p = 0.65).

Conclusions

Breast reconstruction rates continue to rise among IBC patients, particularly young women and women with access to reconstruction. Breast reconstruction is not associated with inferior breast cancer-specific survival and can be an option for select patients.

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Acknowledgment

This work was supported by the Peter Gilgan Center for Research on Women’s Cancers. VG is supported by a Canadian Institutes of Health Research (CIHR) Frederick Banting & Charles Best Canada Graduate Scholarship – Doctoral Research Award. DWL is supported by the CIHR Fellowship and the Canadian Cancer Society Chair in Breast Cancer Research at Women’s College Research Institute (Women’s College Hospital, Toronto, ON, Canada), and is also the recipient of a 2021 Conquer Cancer Young Investigator Award for Invasive Lobular Carcinoma Research supported by Conquer Cancer, the ASCO Foundation, and the Lobular Breast Cancer Alliance. SAN is supported by a Tier 1 Canada Research Chair in Breast Cancer.

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Authors and Affiliations

  1. Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada

    Ananya Gopika Nair BHSc, John L. Semple MD & Steven A. Narod MD

  2. Women’s College Research Institute, Women’s College Hospital, Toronto, ON, Canada

    Vasily Giannakeas MPH, John L. Semple MD, Steven A. Narod MD & David W. Lim MDCM, MEd, PhD

  3. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada

    Vasily Giannakeas MPH & Steven A. Narod MD

  4. Department of Surgery, Women’s College Hospital, Toronto, ON, Canada

    John L. Semple MD & David W. Lim MDCM, MEd, PhD

  5. Division of Plastic, Reconstructive and Aesthetic Surgery, Department of Surgery, University of Toronto, Toronto, ON, Canada

    John L. Semple MD

  6. Institute of Medical Science, University of Toronto, Toronto, ON, Canada

    Steven A. Narod MD

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Correspondence to David W. Lim MDCM, MEd, PhD.

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Ananya Gopika Nair, Vasily Giannakeas, John L. Semple, Steven A. Narod, and David W. Lim declare they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

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This work was presented as a poster presentation at the 23rd Annual Meeting of the American Society of Breast Surgeons (ASBrS), 6–10 April 2022, Las Vegas, NV, USA, and was selected as one of the top 10 posters.

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Nair, A.G., Giannakeas, V., Semple, J.L. et al. Contemporary Trends in Breast Reconstruction Use and Impact on Survival Among Women with Inflammatory Breast Cancer. Ann Surg Oncol 29, 8072–8082 (2022). https://doi.org/10.1245/s10434-022-12408-0

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