FREQUENCY OF RECURRENCES AND METASTASES IN WOMEN OF REPRODUCTIVE AGE DEPENDING ON THE TYPE OF RADICAL MASTECTOMY
DOI: 10.22138/2500-0918-2018-15-6-770-778
V.E. Karasev, V.T. Dolgikh, A.V. Ershov
Clinical Oncology Dispensary, Omsk, Russian Federation;
Omsk State Medical University, Omsk, Russian Federation;
V.A. Negovsky Research Institute of General Reanimatology, Moscow, Russian Federation
Abstract. Objective: To identify the incidence of metastases and relapses in women of reproductive age in breast cancer, depending on the type of radical mastectomy. Materials and methods: 274 patients with stage I to IIIA breast cancer aged 18 to 40 years were examined and treated. The first group consisted of women (n = 141), operated in the volume of single-stage radical mastectomy. Group 2 composed of patients (n = 133) who underwent radical mastectomy with a single-stage breast reconstruction. 40 healthy women who underwent mammoplasty were included in group 3. For 5 years, the incidence of metastasis and recurrence was recorded, and the level of cortisol in serum and vanillylmandelic acid in urine was determined before surgery, after 6 months, after 1 year and 5 years after surgery. Research results. The level of cortisol in serum and vanillylmandelic acid in urine before the operation was elevated in all patients. However, a year later and 5 years after the operation, the content of cortisol and vanillylmandelic acid was lower in patients with radical mastectomy. Comparison of the incidence of relapse after mastectomy and mastectomy with simultaneous breast reconstruction over a five-year follow-up allowed us to reveal a certain tendency when analyzing the changes from “year to year”. At the same time, when comparing the total figures for the five-year observation, it was established that in group I relapses developed by 57.8% more often than in group II. In the group of women who underwent only mastectomy, there was an almost twofold increase in the incidence of metastases, starting from the second year of observation. The frequency of metastasis development in both groups, taking into account the stage of the tumor process, differed already after the first year of the postoperative period. In particular, over the next four years of observation, the likelihood of metastasis development in women who underwent only mastectomy was almost twice as high as in women who underwent single-stage mastectomy with simultaneous breast reconstruction, regardless of the stage of breast cancer. Findings. 1. Women who had radical mastectomy were in a state of greater stress than women who underwent mastectomy with simultaneous breast reconstruction. The greater stress increased the incidence of relapses and metastases of breast cancer. 2. Simultaneous reconstruction of mammary glands after mastectomy reduced the likelihood of recurrence and metastases by 2 times in comparison with radical mastectomy.
Keywords: breast cancer, simultaneous breast reconstruction, mastectomy, relapse, metastasis
There is no conflict of interest
Contact details of the corresponding author:
Vladimir E. Karasev
kobra919@yandex.ru
Received 21.12.2018
For citation:
Karasev V.E., Dolgikh V.T., Ershov A.V. Frequency of recurrences and metastases in women of reproductive age depending on the type of radical mastectomy. Vestn. Ural. Med. Akad. Nauki. = Journal of Ural Medical Academic Science. 2018, Vol. 15, no. 6, pp. 770–778. DOI: 10.22138/2500-0918-2018-15-6-770-778 (In Russ)
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Authors:
Vladimir E. Karasev
Cand. Sci. (Med), Oncologist of Surgical Department No.3 of Clinical Oncology Dispensary, Omsk
Assistant Professor of Radiation Oncology Department of Omsk State Medical University
Zavertyaeva Str. 9, Omsk, Russian Federation, 644013
kobra919@yandex.ru
Vladimir T. Dolgikh
Dr. Sci. (Med), Professor, Honored Worker of Science of Russia, Chief Researcher
V.A. Negovsky Research Institute of General Reanimatology
Petrovka Str. 25, Moscow, Russian Federation 107031 prof_dolgih@mail.ru
Anton V. Ershov
Dr. Sci. (Med), Senior Researcher
V.A. Negovsky Research Institute of General Reanimatology
Petrovka Str. 25, Moscow, Russian Federation 107031
salavatprof@mail.ru
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)