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Updated: Jul 15, 2025
Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
Neoadjuvant chemotherapy impact on outcomes in immediate breast reconstruction with latissimus dorsi flap and
Gabriel Salum D'Alessandro1, Alexandre Mendonça Munhoz2,3, Fabiana Midori Takeuchi4
1Breast and Plastic Surgery Division, Instituto Brasileiro de Controle do Cancer (IBCC), São Paulo, Brazil.
Background And Objectives:
Neoadjuvant chemotherapy (NCH) has demonstrated efficacy in downsizing tumors and facilitating less extensive surgery. However, immediate breast reconstruction (IBR) after NCH has raised concerns regarding higher complication rates. This study evaluates the impact of NCH on outcomes following IBR with a latissimus dorsi flap and implant (LDI) after mastectomy.
Methods:
Cases from a prospective maintained database were reviewed, and patients classified according to whether or not they received NCH. Risk factors and major and minor complications in both groups were then analyzed.
Results:
Among the 196 patients who underwent 198 IBR procedures, 38.4% received NCH and 66.1% did not. The overall complication rate was 46.7% in the non-NCH group and 53.3% in the NCH group (p = 0.650). The presence of comorbidities increased the likelihood of any complication (odds ratio [OR]: 3.46; 95% confidence interval [CI]: 1.38-8.66; p = 0.008) as well as major complications (OR: 3.35; 95% CI: 1.03-10.95; p = 0.045). Although patients in the NCH group experienced more major complications (10.5% vs. 4.9%; p = 0.134) and early loss of breast reconstruction (3.9% vs. 0.8%; p = 0.128), these findings were not statistically significant.
Conclusion:
This study found no statistically significant association between NCH and higher risk of complications or loss of IBR with LDI after mastectomy.
