Neoadjuvant chemotherapy and DTI-reconstruction in breast cancer patients
Zikiryakhodzhaev A.D., Bosieva A.R.
Neoadjuvant polychemotherapy (NACT) is currently the cornerstone in the treatment of locally advanced breast cancer (BC) and highly chemosensitive tumors, such as triple-negative and HER/neu-positive types. The lack of clear consensus on the optimal method of breast reconstruction after NACT has resulted in a wide variety of techniques used in practice. The factors which influence the choice of surgical intervention also remain unclear.
The databases and systems, namely PubMed, Cochrane Library, eLibrary have been searched for articles published from 2012 to 2023; this review includes the results of 27 studies.
The information about the possibility of performing and expanding indications for organ-preserving treatment, performing reconstructive plastic surgery, including one-stage reconstructions using allomaterials after NACT reflects current national and global trends in the treatment of patients with breast cancer. When performing a one-stage reconstruction, various methods of reconstruction can be used: reconstruction with own tissues, reconstruction with the use of allomaterials, reconstruction with a thoracodorsal flap in combination with an endoprosthesis/tissue expander, etc. There are the following indications for performing a mastectomy with one-stage or two-stage reconstruction after NACT: the absence of a tumor response to NACT (NR); in case of a partial response, the ratio of the size of the residual tumor and the size of the breast does not allow performing an organ–preserving operation (OPO) and, therefore, achieving a satisfactory aesthetic result; if an interstitial marker is not placed in the tumor node before NACT (in CR and PR); the patient does not want an OPO, but at the same time she has a wish to maintain a satisfactory aesthetic result after surgery.
Conclusion: Performing one-stage breast reconstruction using allomaterials (DTI-reconstruction) is safe in term of oncology and it does not increase the incidence of surgical complications. The esthetic results of the operation are also comparable with similar parameters of patients who did not undergo NACT at the first stage.
Authors’ contributions: Zikiryakhodzhaev A.D., Bosieva A.R. – developing the concept and design of the study; Bosieva A.R. – collecting and processing data, writing the text; Zikiryakhodzhaev A.D. – editing the text.
Conflicts of interest: Authors declare lack of the possible conflicts of interest.
Funding: The study was conducted without sponsorship.
For citation: Zikiryakhodzhaev A.D., Bosieva A.R. Neoadjuvant chemotherapy and DTI-reconstruction in breast cancer patients.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2024; (2): 31-36 (in Russian)
https://dx.doi.org/10.18565/aig.2023.252
Keywords
breast cancer
neoadjuvant chemotherapy
one-stage breast reconstruction
allomaterials
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Received 08.11.2023
Accepted 24.01.2024
About the Authors
Azizjon D. Zikiryakhodzhaev, Dr. Med. Sci., Professor, Head of the Department of Oncology and Reconstructive Plastic Surgery of the Breast and Skin, P.A. Herzen Moscow Research Institute of Oncology – branch of the National Medical Research Center of Radiology, Ministry of Health of Russia, 125284, Russia, Moscow, 2nd Botkinsky passage, 3; Professor of the Department of Oncology, Radiotherapy and Plastic Surgery, Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University,Ministry of Health of Russia (Sechenov University), 119991, Russia, Moscow, Trubetskaya str., 8-2; Professor of the Department of Oncology and X-ray Radiology named after
V.P. Kharchenko, Medical Institute, RUDN University, 117198, Russia, Moscow, Miklukho-Maklaya str., 6, azizz@mail.ru, https://orcid.org/0000-0001-7141-2502
Alana R. Bosieva, PhD, Researcher at the Department of Oncology and Reconstructive Plastic Surgery of the Breast and Skin, P.A. Herzen Moscow Research Institute of Oncology – branch of the National Medical Research Center of Radiology, Ministry of Health of Russia, 125284, Russia, Moscow, 2nd Botkinsky passage, 3; Assistant at the Department of Oncology and X-ray Radiology named after V.P. Kharchenko, Medical Institute, RUDN University, 117198, Russia, Moscow, Miklukho-Maklaya str., 6, +7(988)875-10-47, ms.bosieva@mail.ru, SPIN-code: 1090-7281, https://orcid.org/0000-0003-0993-8866
Corresponding author: Alana R. Bosieva, ms.bosieva@mail.ru
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