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[DOES NEOADJUVANT CHEMOTHERAPY AFFECT THE IMMEDIATE POSTOPERATIVE COMPLICATION RATE AFTER BREAST RECONSTRUCTION?]
Sharon Kracoff-Sella1, Tanir Allweis2,3, Dana Egozi1,3
1The Department of Plastic Surgery, Kaplan Medical Center.
Harefuah
|August 28, 2020
Summary
Neoadjuvant chemotherapy (NAC) before breast cancer surgery does not increase the risk of complications during immediate breast reconstruction. This study found no significant difference in post-operative issues, suggesting NAC is safe for patients undergoing reconstruction.
Area of Science:
- Oncology
- Plastic Surgery
- Surgical Oncology
Background:
- Neoadjuvant chemotherapy (NAC) is a safe and effective breast cancer treatment that reduces tumor size for less invasive surgery.
- Concerns exist regarding NAC's potential to increase infection risk after immediate breast reconstruction due to immunosuppression.
- Limited research addresses NAC's impact on post-operative complications in breast reconstruction.
Purpose of the Study:
- To evaluate the association between neoadjuvant chemotherapy (NAC) and immediate post-operative complications in patients undergoing breast cancer surgery with immediate reconstruction.
- To determine if NAC influences the rates of infection, skin necrosis, wound dehiscence, hematoma, seroma, or implant explantation.
Main Methods:
- A retrospective review of 158 patients (205 breasts) who had breast cancer surgery with immediate reconstruction between 2013-2017.
- Univariate and multivariate statistical analyses were used to compare patient characteristics and outcomes based on NAC administration.
- Focused analysis on immediate post-operative complications including infection, skin necrosis, wound dehiscence, hematoma, seroma, and implant explantation.
Main Results:
- Fifty-two patients received NAC; 106 did not. The NAC group was younger (45 vs. 51 years).
- Overall complication rates showed a trend towards being lower in the NAC group (23% vs. 34%, P=0.2), though not statistically significant.
- Infection rates also trended lower in the NAC group (3.8% vs. 11.3%, P=0.12). Mastectomy, implant reconstruction, and diabetes were linked to higher complication rates.
Conclusions:
- Neoadjuvant chemotherapy (NAC) is not associated with an increased risk of immediate post-operative complications in breast surgery and reconstruction.
- Immediate breast reconstruction can be safely performed in patients who have received NAC.
- NAC should not be a contraindication for patients considering immediate breast reconstruction.
