Surgical Outcomes for Mastectomy Patients Receiving Neoadjuvant Chemotherapy: A Propensity-Matched Analysis

Area of Science:

• Oncology
• Surgical Oncology
• Clinical Research

Background:

• Postoperative complications are a concern for mastectomy patients.
• Neoadjuvant chemotherapy is suspected to increase surgical risk, but lacks rigorous evaluation.

Purpose of the Study:

• To assess the surgical morbidity risk associated with neoadjuvant chemotherapy prior to mastectomy.
• To evaluate the impact of neoadjuvant chemotherapy on postoperative complications.

Main Methods:

• A 1:1 matched propensity analysis of 31,130 patients from the American College of Surgeons National Surgical Quality Improvement Program (2006-2012).
• Included females with invasive breast cancer undergoing planned mastectomy, matched on preoperative variables and surgical procedures.
• Examined outcomes included wound complications, sepsis, and unplanned return to the operating room.

Main Results:

• No significant difference in superficial wound complications (2.24% vs 2.45%, P=0.627).
• Similar rates of return to the operating room (5.7% vs 5.2%, P=0.445).
• No increased risk of sepsis (0.37% vs 0.46%, P=0.654) in the neoadjuvant chemotherapy group.

Conclusions:

• Neoadjuvant chemotherapy does not elevate surgical morbidity risk in breast cancer patients.
• This large, matched cohort study controlled for key risk factors and surgical procedures.