Post-Operative Complications Do Not Influence Time to Adjuvant Treatment in Breast Cancer Patients Undergoing...

Area of Science:

• Plastic Surgery
• Oncology
• Surgical Innovation

Background:

• Immediate breast reconstruction post-mastectomy is trending towards less invasive techniques.
• The pre-pectoral approach minimizes muscle dissection, potentially reducing pain and recovery time.
• Concerns remain regarding complications and their effect on adjuvant treatment schedules.

Purpose of the Study:

• To compare post-operative complications and adjuvant treatment timing between pre-pectoral and sub-pectoral implant-based breast reconstruction.
• To identify factors influencing delayed adjuvant therapy initiation following mastectomy reconstruction.

Main Methods:

• Retrospective analysis of 622 patients undergoing mastectomy with implant-based breast reconstruction (January 2014 - March 2024).
• Patients were categorized into pre-pectoral or sub-pectoral reconstruction groups.
• Data collected included demographics, oncologic details, surgical outcomes, complications, and adjuvant therapy timing.

Main Results:

• Complication rates were similar between pre-pectoral (20.2%) and sub-pectoral (23.8%) reconstructions (p=0.310).
• Pre-pectoral reconstruction had higher rates of delayed wound healing (9.0% vs 4.3%), while sub-pectoral had more post-operative bleeding (4.9% vs 0.4%).
• Operative time was significantly shorter for pre-pectoral reconstruction (p < 0.001); reconstruction technique did not predict adjuvant therapy delays.

Conclusions:

• The pre-pectoral approach is a viable alternative to sub-pectoral reconstruction with comparable overall complication rates.
• Factors like smoking, diabetes, and skin-reducing mastectomy, not the reconstruction technique, predict delays in adjuvant therapy.
• Pre-pectoral breast reconstruction does not negatively impact the initiation of adjuvant treatments.