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首页> 外文期刊>Breast cancer research and treatment. >The recurrence pattern following delayed breast reconstruction after mastectomy for breast cancer suggests a systemic effect of surgery on occult dormant micrometastases
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The recurrence pattern following delayed breast reconstruction after mastectomy for breast cancer suggests a systemic effect of surgery on occult dormant micrometastases

机译：乳腺癌乳房切除术后延迟乳房重建后的复发模式提示手术对隐匿性休眠的微转移有全身性作用

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The purpose of this study was to characterize the recurrence dynamics in breast cancer patients after delayed reconstruction. We hypothesized that surgical reconstruction might stimulate dormant micrometastases and reduce time to recurrence. All mastectomy breast cancer patients with delayed surgical reconstruction at Haukeland University Hospital, between 1977 and 2007, n = 312, were studied. Our control group consisted of 1341 breast cancer patients without reconstruction. For each case, all patients in the control group with identical T and N stages and age +/- 2 years were considered. A paired control was randomly selected from this group. 10 years after primary surgery, 39 of the cases had relapsed, compared to 52 of the matched controls. The reconstructed group was analyzed for relapse dynamics after mastectomy; the first peak in relapses was similarly timed, but smaller than for the controls, while the second peak was similar in time and size. Second, the relapse pattern was analyzed with reconstruction as the starting point. A peak in recurrences was found after 18 months, and a lower peak at the 5th-6th year. The height of the peak correlated with the extent of surgery and initial T and N stages. Timing of the peak was not affected, neither was the cumulative effect. The relapse pattern, when time origin is placed both at mastectomy and at reconstruction, is bimodal with a peak position at the same time points, at 2 years and at 5-6 years. The timing of the transition from dormant micrometastases into clinically detectable macrometastases might be explained by an enhancing effect of surgery.
机译：这项研究的目的是表征延迟重建后乳腺癌患者的复发动态。我们假设手术重建可能会刺激休眠的微转移并减少复发时间。于1977年至2007年间，在Haukeland大学医院对所有延迟手术重建的乳房切除术乳腺癌患者进行了研究，n = 312。我们的对照组由1341例未经重建的乳腺癌患者组成。对于每种情况，都考虑了对照组中所有具有相同T和N分期且年龄+/- 2岁的患者。从该组中随机选择配对对照。初次手术后10年，有39例病例复发，而对照组为52例。分析重建组的乳房切除术后复发动态。复发的第一个峰的时间类似，但比对照组小，而第二个峰的时间和大小相似。其次，以重建为起点分析复发模式。 18个月后发现复发高峰，而在第5-6年发现较低的复发高峰。峰的高度与手术程度以及最初的T和N阶段相关。高峰时间不受影响，累积效应也不受影响。当时间起点同时在乳房切除术和重建术中放置时，复发模式是双峰的，在同一时间点，2年和5-6年时达到峰值位置。从休眠的微转移过渡到临床上可检测的宏观转移的时机可能是通过提高手术效果来解释的。

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