Triple-negative breast cancer patients treated with subcutaneous mastectomy with immediate reconstruction: single institution experience

Introduction:
Triple-negative breast cancer (TNBC) accounts for approximately 15–20% of all breast carcinomas. In the last two decades, both nipple-sparing mastectomy (NSM) and skin-sparing mastectomy (SSM) with immediate reconstruction have been used in the surgical management. The aim of our study was to analyze the outcomes of the combined treatment of patients with TNBC treated with NSM or SSM.

Material and methods:
A total of 114 women with TNBC were enrolled in this study. All diagnostic, therapeutic and follow-up procedures were conducted in one center of the Holycross Cancer Centre in Kielce. In all patients, subcutaneous mastectomy was performed. Overall survival was estimated by the Kaplan-Meier method. The influence of selected prognostic factors on the risk of death was analyzed using the Cox proportional hazards models.

Results:
The probability of survival at 1, 3, and 5 years was 0.982, 0.894, 0.850, respectively. Based on the 5-factor Cox model, all included features had a significant relationship with the risk of death. In conclusion, the presence of a genetic mutation, adjuvant chemotherapy, complete pathological regression, and the absence of radiotherapy significantly reduced the risk of death.

Conclusions:
The results of the treatment with subcutaneous mastectomy are good. The early stage of the cancer is associated with a better prognosis. Complete pathological regression after systemic treatment, particularly in patients with BRCA1 mutation, is a good prognostic factor and can help diminish the range of surgery in the axilla region.