Survival Differences in Women with and without Autologous Breast Reconstruction after Mastectomy for Breast Cancer
Research article published in Plastic and reconstructive surgery. Global open (2017)
Abstract
BACKGROUND: Breast reconstruction (BR) is an option for women who are treated with mastectomy; however, there has been concern regarding the oncologic safety of BR. In this study, we evaluated recurrences and mortality in women treated with mastectomy and compared outcomes in those treated with mastectomy alone to those with mastectomy plus transverse rectus adbominis (TRAM) flap BR. METHODS: The prospective cohort study included women treated with mastectomy at Women's College Hospital from 1987 to 1997. Women with TRAM flap BR were matched to controls based on age and year of diagnosis, stage, and nodal status. Patients were followed from the date of diagnosis until death or date of last follow-up. Hazard ratios were generated to compare cases and controls for outcome variables using Cox's proportional hazards models. RESULTS: Of 443 women with invasive breast cancer, 85 subjects had TRAM flap BR. Sixty-five of these women were matched to 115 controls. The mean follow-up was 11.2 (0.4-26.3) years. There were no significant differences between those with and without BR with weight, height, or smoking status. Women with TRAM flap were less likely to experience a distant recurrence compared to women without a TRAM flap (relative risk, 0.42; P = 0.0009) and were more likely to be alive (relative risk, 0.54; P = 0.03). CONCLUSIONS: Women who elect for TRAM flap BR after an invasive breast cancer diagnosis do have lower rates of recurrences and mortality than women treated with mastectomy alone. This cannot be explained by differences in various clinical or lifestyle factors.
Abstract sourced from PubMed (NCBI) for the cited record. See the original publication for the authoritative version.
Resumen
Peer-reviewed clinical and outcomes research relevant to medicinal leech therapy and its biology. Indexed in PubMed and verified against the NCBI record.
Por qué esto importa para la hirudoterapia
Este estudio de cohorte prospectivo emparejado publicado en Plastic and Reconstructive Surgery Global Open (2017) evaluó la seguridad oncológica de la reconstrucción mamaria autóloga comparando mujeres tratadas con mastectomía sola con aquellas con mastectomía más reconstrucción con colgajo TRAM en un único hospital (1987-1997); según el resumen, entre las pacientes emparejadas (65 con colgajo TRAM, 115 controles, seguimiento medio de 11,2 años) las mujeres con reconstrucción con colgajo TRAM presentaron menor recurrencia a distancia (riesgo relativo 0,42, P=0,0009) y mayor supervivencia (riesgo relativo 0,54, P=0,03), no explicado por los factores clínicos o de estilo de vida medidos. Es relevante para la hirudoterapia como contexto sobre la reconstrucción con colgajo TRAM, un tipo de colgajo cuya congestión venosa postoperatoria es una indicación para la sanguijuela medicinal autorizada por la FDA, enmarcando la población clínica en la que se utilizan dichos colgajos. Caveat: se trata de una cohorte observacional emparejada, no un ensayo aleatorizado, por lo que la asociación de los autores entre la reconstrucción y la mejora de la supervivencia está sujeta a confusión residual y efectos de selección, y no establece causalidad; el estudio no aborda la congestión venosa ni la hirudoterapia.
Citación
Survival Differences in Women with and without Autologous Breast Reconstruction after Mastectomy for Breast Cancer.
L et al. · Plastic and reconstructive surgery. Global open, 2017
Contexto clínico relacionado
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Añadido a la biblioteca ASH: May 28, 2026 · Última actualización del sitio: 18 de junio de 2026