Breast Cancer Subtype Approximations and Locoregional Recurrence After Immediate Breast Reconstruction

Maximiliano Kneubil, Janaina Brollo, Giuseppe Botteri, Janaina Curigliano, Nicole Rotmensz, Aron Goldhirsch, Visnu Lohsiriwat, Andrea Manconi, Stefano Martella, Barbara Santillo, Jean Petit, Mario Rietjens

Abstract


INTRODUCTION: A minority, but significant, proportion of breast cancer(BC) patients will develop locoregional recurrence after immediate breast reconstruction (LRR). The LRR also varies according to breast cancer subtypes and clinicopathological features.
METHODS: We studied 1,742 consecutive patients between 1997-2006. Five BC subtypes were approximated: estrogen receptor (ER) and/or progesterone receptor (PgR) positive, HER2 negative, and low Ki67 (< 14%) (ie, luminal A); ER and/or PgR positive, HER2 negative and high Ki67 (14%)
(ie, luminal B/HER2 negative); ER and/or PgR positive, any Ki67 and HER2 positive (ie,luminal B/
HER2 positive); ER negative, PgR negative and HER2 positive (ie, HER2 positive/non luminal); and ER negative, PgR negative and HER2 negative (ie, triple negative). Cumulative incidences of LRR were compared across different subgroups by means of the Gray test. Multivariable Cox regression models were applied.
RESULTS: Median follow up time was 74 months (range 3-165). The cumulative incidence of LRR was 5.5% (121 events). The 5-year cumulative incidence of LRR was 2.5% for luminal A; 5.0% for luminal B/HER2 negative; 9.8% for luminal B/HER2 positive; 3.8% for HER2 non luminal; and 10.9% for triple negative. On multivariable analysis, tumor size (pT) > 2 cm, BMI 25, triple negative and luminal B/ HER2 positive subtypes were associated with increased risk of LRR.
CONCLUSION: BC subtyping is an independent prognostic factor of LRR after IBR. Information on BC subtypes, BMI and tumor size can predict the risk of LRR. Assessment of the potential oncologic LRR risk and psychological benefit should be discussed before offering IBR.

SIS Journal is the Electronic Journal of the Senologic International Society, the World Society of Breast Diseases. ISSN: 1688-8170