Breast conserving surgery is an oncologically safe method for patients, who underwent breast augmentation prior to their breast cancer diagnosis

초록

Background: Breast cancer has the highest incidence among Korean women, with growing occurrences of breast augmentation worldwide consequently, the number of breast cancer patients with previous augmentation is also increasing. Surgical management of these patients remains controversial, as breast-conserving surgery (BCS) with radiation therapy presents challenges, such as capsular contracture, poor cosmetic outcomes, and difficulty obtaining clear resection margins. This retrospective study assesses the safety and feasibility of BCS with radiation therapy in breast cancer patients with prior breast augmentation. Material and Methods: We conducted a retrospective review of 4,568 patients who underwent breast cancer surgery at Korea University Guro Hospital from 2008 to 2023. Among these, 17 patients had a history of breast augmentation prior to their breast cancer diagnosis. Clinical charts, breast imaging, pathologic reports, and surgical records were reviewed to collect data on cancer diagnosis, implant placement, cancer stage, histology, treatment details, and recurrence rates. Breast volume was measured using mammography after surgery and radiation therapy to assess symmetry. Results: Seventeen patients with prior breast augmentation were treated for breast cancer, with an average age of 46 years. Sixteen patients underwent BCS, while one required a mastectomy due to extensive microcalcification and multiple masses. Tumor stages ranged from DCIS to stage IIB. There was only one case of recurrence after 7 years from the initial surgery. The average difference in breast volume between treated and untreated breasts was 104ml. there were no cases of implant rupture or removal during the primary surgery. Conclusions: The study suggests that BCS accompanied by radiation therapy is an oncologically safe approach for breast cancer patients who have had prior breast augmentation, as adequate surgical margins were achieved in most cases. However, BCS may lead to breast volume asymmetry, and further research is necessary to evaluate the cosmetic outcomes and patient satisfaction postoperatively. No conflict of interest