Background: Implant-based breast reconstruction (IBBR) following conservative mastectomy is the most common approach for women undergoing breast cancer surgery. The aim of this study was to compare the oncological outcomes of conservative mastectomy combined with prepectoral IBBR to the subpectoral technique. Methods: The clinical and demographic data of consecutive breast cancer patients who underwent conservative mastectomy with either prepectoral or subpectoral IBBR between January 2018 and December 2023 were retrospectively analyzed. The primary outcome was the impact of conservative mastectomy with prepectoral IBBR on local recurrence-free survival (LRFS). Secondary outcomes included distant disease-free survival (DDFS) and overall survival (OS). Results: A total of 842 women (with a median age of 46 years and a range of 20–79 years) were included in the study. Of these, 648 patients (77.0%) underwent prepectoral IBBR, while 194 (23.0%) received subpectoral IBBR. The median follow-up was 32 months (3–74). Locoregional relapse occurred in 19 patients (2.9%) in the prepectoral group and 14 (7.2%) in the subpectoral group. Distant metastases were observed in 21 (3.2%) patients in the prepectoral group and 11 (5.7%) in the subpectoral group. Deaths were reported in eight patients (1.2%) in the prepectoral group and five (2.6%) in the subpectoral group. There were no statistically significant differences between the two groups in terms of the LRFS, DDFS, and OS (p= 0.676;p= 0.994;p= 0.940, respectively). Conclusions: Our study indicates that conservative mastectomy combined with prepectoral IBBR produces similar results to those of the subpectoral approach, with no significant differences in LRFS, DDFS, and OS.
背景：保乳术后基于植入物的乳房重建（IBBR）是乳腺癌手术女性最常用的方法。本研究旨在比较保乳术联合胸肌前IBBR与胸肌下技术在肿瘤学预后方面的差异。方法：回顾性分析了2018年1月至2023年12月期间连续接受保乳术联合胸肌前或胸肌下IBBR的乳腺癌患者的临床和人口统计学数据。主要研究终点是保乳术联合胸肌前IBBR对局部无复发生存期（LRFS）的影响。次要研究终点包括无远处转移生存期（DDFS）和总生存期（OS）。结果：研究共纳入842名女性（中位年龄46岁，范围20-79岁）。其中，648名患者（77.0%）接受了胸肌前IBBR，194名患者（23.0%）接受了胸肌下IBBR。中位随访时间为32个月（范围3-74个月）。胸肌前组有19名患者（2.9%）发生局部区域复发，胸肌下组有14名患者（7.2%）。胸肌前组有21名患者（3.2%）观察到远处转移，胸肌下组有11名患者（5.7%）。胸肌前组报告8名患者（1.2%）死亡，胸肌下组报告5名患者（2.6%）死亡。两组在LRFS、DDFS和OS方面均无统计学显著差异（p值分别为0.676、0.994、0.940）。结论：我们的研究表明，保乳术联合胸肌前IBBR与胸肌下方法效果相似，在LRFS、DDFS和OS方面无显著差异。
肿瘤(癌症)患者之家