Effectiveness of post-mastectomy radiation therapy after breast reconstruction for patients with high-risk breast cancer: A retrospective multicenter cohort study (Reborn Study-03)
Menée à l'aide de données portant sur 1 138 patientes atteintes d’un cancer du sein à haut risque (durée médiane de suivi : 8 ans), cette étude analyse l'efficacité, du point de vue du taux de récidive locale, d'une radiothérapie post-mastectomie chez les patientes ayant bénéficié d'une reconstruction mammaire
Introduction: Post-mastectomy radiation therapy (PMRT) is a standard treatment modality for patients with high-risk breast cancer. Although it is performed in patients who undergo breast reconstruction (BR), PMRT efficacy following BR in patients with high-risk breast cancer remains unclear. We evaluated the effectiveness of PMRT in patients with high-risk breast cancer who underwent BR.
Materials and Methods: This 15-institution retrospective cohort study included patients with high-risk breast cancer who underwent immediate or delayed BR after mastectomy between 2008 and 2018. High-risk patients were defined as those with positive axillary lymph nodes, clinical tumor size of >5 cm, chest wall invasion, or skin invasion.
Results: Of the 1,138 included patients, 427 (37.5%) received PMRT, whereas 711 (62.5%) did not. The median age at surgery was 46 (range 23–76) years, and the median follow-up period was 8 years. Overall, 149 (34.9%) and 81 (11.4%) patients in the PMRT and non-PMRT cohorts, respectively, met >2 high-risk criteria. Breast implant-based reconstruction was performed in 71.9% and 64.0% of patients in the PMRT and non-PMRT cohorts, respectively. The 8-year median locoregional recurrence (LRR) rates were significantly lower in the PMRT cohort (5.4%) than in the non-PMRT cohort (12.8%) (p < 0.001). PMRT was an independent predictive factor for LRR (hazard ratio: 0.341, 95% confidence interval: 0.200–0.584, p < 0.001).
Conclusion: PMRT following BR for patients with high-risk breast cancer was associated with significantly lower LRR rates, indicating its effectiveness for improving survival in this population.
European Journal of Surgical Oncology , résumé, 2025