Reconstructive surgery might speed up return of breast cancer
A new study suggests that reconstruction of breast affects recurrence of breast cancer, and actually reduce time to relapse of the disease. The study was recently presented as front page news in the journal Breast Cancer Research and Treatment, with main author Hanna Dillekås who is PhD candidate at Professor Oddbjørn Straumes group. Straume is CCBIO PI and also last author of the study.
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The other co-authors are Svein A. H. Jensen, senior consultant at the plastic surgery department at Haukeland University Hospital and associate professor at the University of Bergen, and a research team at the National Cancer Institute of Milan, Italy.
The hypothesis was that surgery affect recurrence dynamics in breast cancer, i.e. that surgical reconstruction might stimulate dormant micrometastases and reduce time to recurrence. 312 patients who in a thirty-year period received delayed reconstruction at Haukeland University Hospital, were included in the study. In addition the study included a control group of 1,341 breast cancer patients who have not received a new breast after cancer surgery.
"There have previously been studies on effects of primary surgery, but we have also looked at recurrence after delayed reconstruction", says Hanna Dillekås in an interview with Dagens Medisin.
"We found that recurrences came in the same pattern both after primary surgery and reconstruction; first after two years and then after 5-6 years. In the reconstruction group, recurrence peaks came regardless of the time interval from primary surgery. This suggests that it is actually the reconstruction which affects recurrence dynamics", says Dillekås.
In 2012 and 2013, the Health Minister of the time, Jonas Gahr Støre, granted NOK 150 million for breast reconstruction to reduce the wait, which for some women had been up to eight years.
One other measure was that more patients should have breast reconstruction in the same operation as the cancer surgery, when the disease permitted it. This study supports such an approach.
Dillekås emphasizes that we need to be careful with what conclusions we draw from the study.
"There is no basis for saying that reconstruction is dangerous, and we do not want to scare breast cancer patients from getting reconstruction. What we see is that recurrence, when it in any case would have come later, seems to occur more often about 18 months after delayed reconstruction."
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Complete interview in Dagens Medisin (in Norwegian).
The publication is available through this link.
Also read more about Oddbjørn Straume's research group.