A.Kh. Ismagilov1, V.Ye. Karasev2, 3, D.M. Vyushkov3
1Kazan State Medical Academy, Kazan
2Omsk State Medical University, Omsk
3Clinical Oncology Dispensary, Omsk
Karasev V.E. – PhD Medicine), Head of the Surgical Department of Breast Tumors and Soft Tissue
12 Lenin St., 644099 Omsk, Russian Federation, e-mail: kobra919@yandex.ru
Abstract. The study objective was to evaluate the impact of reconstructive plastic surgery on the psycho-emotional state, stress level and metastasis rate of unilateral breast cancer of various biological subtypes.
Material and methods. The incidence of metastasis was studied in 577 young patients who underwent surgical treatment for unilateral breast cancer of stages I–IIIA: 43.5% of cases – mastectomy by Madden, 34.8% – mastectomy and immediate two-stage reconstruction, 21.7% – mastectomy and delayed two-stage reconstruction.
Results. Metastasis is more common in patients with very high or extremely low levels of cortisol in the blood and vanillylmindic acid in the urine (G = 0.24, p = 0.041). Over 5 years of follow-up, distant metastases were detected in 12.4% of cases after immediate reconstruction of the breast, after delayed reconstruction – in 12%, while in patients who underwent only radical mastectomy without reconstruction, metastases were detected in 16.3% of cases.
Conclusions. Studying the dynamics of the stress hormones may help to distinguish the risk group for metastasis among treated patients with breast cancer. Reconstructive plastic surgery with silicone implants does not increase the risk of breast tumor metastasis and can be recommended in clinical practice, including as a means of psychological assistance to patients aimed at reducing anxiety and depression, stress levels and disease progression.
Key words: biological type of tumor, metastases, breast cancer, reconstructive plastic surgery, stress.