ArticleTranslational oncology2026
Impact of breast reconstruction and different surgical approaches after neoadjuvant therapy on the long-term survival of breast cancer patients.
Article in Translational oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
introductionLarge-scale studies on long-term survival after breast reconstruction (BR) following neoadjuvant therapy (NAT) are limited. This study compares long-term survival in breast cancer patients who had BR after NAT-either with nipple-sparing mastectomy (NSM) or total mastectomy (TM)-versus TM alone, to identify subgroups most likely to benefit.
methodsWe analyzed female breast cancer patients who received NAT in the SEER database, stratifying them into three groups: NSM with BR (n = 949), TM with BR (n = 3554), and TM without BR (n = 5465). Overall survival (OS) and breast cancer-specific survival (BCSS) were assessed using Cox proportional hazards models and propensity score matching (PSM).
resultsA total of 9968 patients were included in this study. Compared with TM alone, patients who underwent TM with BR had similar OS (Model 4, Table 3) and BCSS (HR: 0.90-0.96; all P > .05; Table 3). However, those who underwent NSM with BR were associated with better OS (HR: 0.29-0.60; all P < .05; Table 3) and BCSS (HR:0.31-0.64; all P < .05; Table 3). This association remained significant across PSM and multiple association inference models (Table 4) and was more robust in prespecified subgroups-including those aged <65 years and those with earlier-stage disease (Figure 3).
conclusionsThis nationwide cohort study shows that, among patients receiving NAT, NSM with BR is associated with better OS and BCSS than TM alone-whereas TM with BR showed no survival benefit. NSM with BR is a feasible option for selected patients and warrants prospective validation.
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