XXXX recurrence following postmastectomy reconstruction compared to mastectomy with no reconstruction.

@entity1 @entity5 @entity0
BACKGROUND: Continuing advances in breast reconstruction have provided surgeons with a multitude of reconstructive options. Concerns remain, however, about the effects of the various reconstructive methods on ultimate oncologic outcome. This study compares incidence, detection, and management of recurrent @entity0 in a large series of @entity1 treated with mastectomy alone or with mastectomy and various forms of reconstruction. METHODS: A retrospective analysis was performed on all @entity1 who underwent mastectomy and/or immediate reconstruction for @entity0 at our institution between January 1999 and December 2006. The 921 @entity1 were divided into 2 groups: mastectomy and reconstruction (n = 494) and mastectomy alone (n = 427). All modern reconstructive methods were included. @entity1 were followed for a mean of 4.5 years. RESULTS: The total incidence of recurrence-locoregional and/or distant-was 5.9% in @entity1 who had mastectomy with reconstruction and 11.5% in @entity1 who had mastectomy alone (P < 0.0023). The incidence of locoregional recurrence only was 2.2% in @entity1 who had mastectomy with reconstruction and 4.0% in @entity1 who had mastectomy alone (P = 0.1220). Of the 11 reconstructed @entity1 with a locoregional recurrence, all recurrences were detected by self or clinical examination. Median time to detection was the same in both groups: 1.6 years (P = 0.5471). CONCLUSIONS: Reconstruction with a variety of methods does not adversely affect the incidence or time to detection of recurrent @entity0 . Further, our data point to an important role for physical examination in @entity5 surveillance after mastectomy and reconstruction.
