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\nConstance Valette 1,†, Alexandra Anker 1, *,†, Michael Gerken 2, Stephan Seitz 3, Monika Klinkhammer-Schalke 2, Silvan Eisenmann 1, Marc Ruewe 1, Philipp Unbehaun 1, Lukas Prantl 1 and Vanessa Brébant 1, *  \nAcademic Editor: Manuel Diez-Alonso  \nReceived: 11 November 2025  \nRevised: 15 December 2025  \nAccepted: 25 December 2025  \nPublished: 1 January 2026  \nCopyright: © 2026 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license.  \n1 Department of Plastic, Hand and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, D-93053 Regensburg, Germany; [valette.constancemariecaroline@gmail.com](valette.constancemariecaroline@gmail.com) (C.V.); [silvan.eisenmann@ukr.de](silvan.eisenmann@ukr.de) (S.E.); [marc.ruewe@ukr.de](marc.ruewe@ukr.de) (M.R.); [philipp.unbehaun@ukr.de](philipp.unbehaun@ukr.de) (P.U.); [lukas.prantl@ukr.de](lukas.prantl@ukr.de) (L.P.)  \n2 Tumor Center—Center for Quality Assurance and Health Services Research, University of Regensburg, Am Biopark 9, D-93053 Regensburg, Germany; [michael.gerken@klinik.uni-regensburg.de](michael.gerken@klinik.uni-regensburg.de) (M.G.); [monika.klinkhammer-schalke@ur.de](monika.klinkhammer-schalke@ur.de) (M.K.-S.)  \n3 Department of Obstetrics and Gynecology, Caritas Saint Josef Hospital, University of Regensburg, Landshuter Strasse 65, D-93055 Regensburg, Germany; [sseitz@csj.de](sseitz@csj.de)  \n* Correspondence: [alexandra.anker@ukr.de](alexandra.anker@ukr.de) (A.A.); [vanessa.brebant@ukr.de](vanessa.brebant@ukr.de) (V.B.)† These authors contributed equally to this work.  \nAbstract  \nBackground/Objectives: Breast cancer is the most common cancer among women worldwide. Surgical treatments include breast-conserving therapy (BCT) and mastectomy, often followed by reconstruction, but the impact of reconstruction on locoregional recurrence (LRR) remains unclear. This study evaluated LRR, survival, and risk factors following primary breast reconstruction performed simultaneously with mastectomy compared with mastectomy without reconstruction. Methods: This population-based, retrospective cohort included 2475 women with breast cancer treated between 2004 and 2018 at the Tumor Center and Caritas St. Josef Hospital in Regensburg, Germany. Patients were grouped into not primarily reconstructed, primary autologous reconstruction, primary allogeneic reconstruction, and primary combined reconstruction. Overall survival (OS), recurrence-free survival (RFS), and cumulative recurrence rates (CRR) were assessed using Kaplan–Meier methods and Cox proportional hazards models adjusted for age, nodal status, tumor biology, and adjuvant therapies. Results: Of 14,046 eligible cases, 2475 met inclusion criteria: no primary reconstruction (87%), autologous reconstruction (3.1%), allogeneic reconstruction (9.0%), and combined reconstruction (0.4%) . Patients undergoing reconstruction were younger and more likely to receive chemotherapy. The 5-year OS was 71.8% without primary reconstruction, 82.1% after autologous reconstruction, and 90.0% after allogeneic reconstruction. Allogeneic reconstruction was associated with improved OS (HR 0.570, p = 0.015) and RFS (HR 0.669, p = 0.039), whereas autologous reconstruction was associated with higher hazards of LRR and distant metastases compared to no primary reconstruction.  \nConclusions: The 5-year cumulative LRR was 5.2%, 13.5%, and 4.8%, respectively. Immediate allogeneic reconstruction after mastectomy was therefore associated with favorable survival and recurrence outcomes, while autologous reconstruction was linked to higher LRR and distant metastasis rates in this cohort. The retrospective design, small autologous subgroup, and absence of detailed lifestyle and metabolic data are important limitations o","cbCaibQwV0rHlX3K","https://ap.wps.com/l/cbCaibQwV0rHlX3K","pdf",863480,14,"English","# Abstract\n## Background/Objectives\n## Methods\n## Results\n## Conclusions\n# Introduction","[{\"question\":\"What question does the study address about breast reconstruction and recurrence?\",\"answer\":\"It evaluates whether primary breast reconstruction performed at the time of mastectomy affects locoregional recurrence, survival, and risk factors compared with mastectomy without reconstruction.\"},{\"question\":\"How were patients grouped for analysis?\",\"answer\":\"Patients were grouped into no primary reconstruction, primary autologous reconstruction, primary allogeneic reconstruction, and primary combined reconstruction.\"},{\"question\":\"What were the main survival and recurrence findings for allogeneic versus autologous reconstruction?\",\"answer\":\"Allogeneic reconstruction was associated with improved overall survival and recurrence-free survival, while autologous reconstruction was linked to higher hazards of locoregional recurrence and distant metastases compared with no primary reconstruction.\"}]","Locoregional Breast Cancer Recurrences After Ablatio Mammae and Primary Reconstruction | PDF",1790761477,35]