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Breast. 2013 Oct;22(5):673-5. doi: 10.1016/j.breast.2013.01.002. Epub 2013 Jan 26.

Factors influencing the decision to offer immediate breast reconstruction after mastectomy for ductal carcinoma in situ (DCIS): the Institut Gustave Roussy Breast Cancer Study Group experience.

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1
Department of Breast and Plastic Surgery, Institut Gustave Roussy, Villejuif, France.

Abstract

BACKGROUND:

The increased rate of ductal carcinoma in situ (DCIS) is associated with a rise in indications for mastectomy and immediate breast reconstruction (IBR). The purpose of our study was to evaluate the factors affecting the indications for IBR and its modalities.

STUDY DESIGN:

Data concerning two hundred and thirty-eight consecutive patients with DCIS who had undergone modified radical mastectomy and a sentinel lymph node biopsy (SLNB) between 2005 and 2011 were extracted from our database. We then conducted a comparative study between patients who had undergone IBR and those who had not, to determine which factors affected the decision to offer IBR (LOE II).

RESULTS:

About 57.1% had IBR and 42.9% had no reconstruction. The most common reason why IBR had not been performed was that it had not been proposed by the surgeon (33.4%). Of the 136 patients offered IBR, an implant had been proposed to the majority of them (81.6%). The IBR rate was highest among women under 50 years (52.2%), and was lower among women with diabetes (0.7%) or obesity (8.8%). The choice of reconstruction was not affected by tobacco use or positive SLNB results.

CONCLUSION:

Factors predictive of the IBR reflect the influence of surgeon counselling and, to a lesser extent, consideration of patient comorbidities. However, there is a need to improve patient information and physician referral.

KEYWORDS:

Breast cancer; Breast implant; Ductal carcinoma in situ; Immediate breast reconstruction; Mastectomy

PMID:
23357706
DOI:
10.1016/j.breast.2013.01.002
[Indexed for MEDLINE]

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