A BRILLIANT-BRCA study: residual breast tissue after mastectomy and reconstruction

Orit Kaidar-Person*, Renata Faermann, Dor Polikar, Kfir Cohen, Rinat Bernstein-Molho, Monica Morrow, Liesbeth Jorinne Boersma, Birgitte Vrou Offersen, Philip Poortmans, Miri Sklair-Levy, Debbie Anaby

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Introduction: Different types of mastectomies leave different amounts of residual breast tissue. The significance of the residual breast volume (RBV) is not clear. Therefore, we developed an MRI tool that allows to easily assess the RBV. In this study we evaluated factors associated with RBV after skin or nipple sparing mastectomy (SSM/NSM) in breast cancer BRCA pathogenic variant (PV) carriers who underwent both therapeutic and risk reducing SSM/NSM and its relation to breast cancer outcomes using an innovative MRI-based tool. Methods: Data of breast cancer BRCA PV who were treated between 2006 and 2020 were retrieved from of the oncogenetics unit databases. Only patients who underwent SSM/NSM and had a postoperative breast MRI available for analysis were included. Data collected included demographics, clinicopathological features, and outcomes. The MRI tool was developed by a breast cancer imaging laboratory. A logistic regression test and 95% confidence interval (CI) were used to assess the associated risk of increased RBV. A forward stepwise linear regression was used to correlate tumour-patient specific factors and RBV, and a Kaplan–Meier curve to show the probability of locoregional relapse. Results: A total of 84 patients undergoing 89 mastectomies were included. At a median follow-up of 98 months, 5 local, 2 regional, and 4 distant recurrences were observed. RBV was not significantly related with breast cancer outcomes (p value = NS). A higher body mass index (BMI) was associated with a higher RBV (p < 0.0001). A larger number of involved axillary nodes was associated with a smaller RBV (p = 0.025). The RBV on the risk-reducing mastectomy side was significantly higher compared to the breast cancer side (p value = 0.007). Local recurrences occurred in the vicinity of the primary tumour.

Original languageEnglish
Pages (from-to)359-367
Number of pages9
JournalBreast Cancer Research and Treatment
Volume208
Issue number2
Early online date9 Jul 2024
DOIs
Publication statusPublished - Nov 2024

Keywords

  • Breast tissue
  • MRI
  • Mastectomy
  • Nipple sparing
  • Residual breast
  • Risk reducing mastectomy
  • Skin sparing

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