Rates of Ipsilateral Local-Regional Recurrence in High-Risk Patients Undergoing Immediate Post-Mastectomy Reconstruction (AFT-01)

Abstract Background and objectives Some surgeons remain hesitant to perform immediate breast reconstruction (IBR) in patients with higher risk cancers due to concerns about cancer recurrence and/or detection. Our objective was to determine the rate of ipsilateral local-regional recurrence for stage II/III patients who underwent IBR. Methods The National Cancer Database special study mechanism was used to create a stratified sample of women diagnosed with stage II/III breast cancer from 1,217 facilities. Demographic, tumor, and recurrence data for women who underwent mastectomy with or without IBR were abstracted, including location of recurrence and method of detection. Estimates of 5-year local-regional recurrence rates were calculated and factors associated with recurrence were identified with multivariable Cox regression. Results 13% (692/5,318) of stage II/III patients underwent IBR after mastectomy. Patients undergoing IBR were younger (p Conclusions Women with stage II/III breast cancer selected for IBR had similar rates of ipsilateral local-regional recurrence compared to those undergoing mastectomy alone. Offering IBR after mastectomy in a patient-centered manner to select patients with stage II/III breast cancer is an acceptable consideration. MicroAbstract: We studied 5,318 patients with stage II/III breast cancer who underwent mastectomy with and without immediate reconstruction. Patients selected for reconstruction were younger, with lower tumor burden in the breast and axilla. No difference in rates of ipsilateral local recurrence were observed between patients with and without immediate reconstruction. Offering immediate reconstruction to select high risk patients remains appropriate.