Faculty Collaboration Database

Impact of neoadjuvant chemotherapy on breast reconstruction. Cancer 2011 Jul 01;117(13):2833-41

Date

01/26/2011

Pubmed ID

21264833

Pubmed Central ID

PMC3164976

DOI

10.1002/cncr.25872

Scopus ID

2-s2.0-79959620843 (requires institutional sign-in at Scopus site)   46 Citations

Abstract

BACKGROUND: With advances in oncologic treatment, cosmesis after mastectomy has assumed a pivotal role in patient and provider decision making. Multiple studies have confirmed the safety of both chemotherapy before breast surgery and immediate reconstruction. Little has been written about the effect of neoadjuvant chemotherapy on decisions about reconstruction.

METHODS: The authors identified 665 patients with stage I through III breast cancer who received chemotherapy and underwent mastectomy at Dana-Farber/Brigham & Women's Cancer Center from 1997 to 2007. By using multivariate logistic regression, reconstruction rates were compared between patients who received neoadjuvant chemotherapy (n = 180) and patients who underwent mastectomy before chemotherapy (n = 485). The rate of postoperative complications after mastectomy was determined for patients who received neoadjuvant chemotherapy compared with those who did not.

RESULTS: Reconstruction was performed immediately in 44% of patients who did not receive neoadjuvant chemotherapy but in only 23% of those who did. Twenty-one percent of neoadjuvant chemotherapy recipients and 14% of adjuvant-only chemotherapy recipients underwent delayed reconstruction. After controlling for age, receipt of radiotherapy, and disease stage, neoadjuvant recipients were less likely to undergo immediate reconstruction (odds ratio [OR], 0.57; 95% confidence interval [CI], 0.37, 0.87) but were no more likely to undergo delayed reconstruction (OR, 1.29; 95% CI, 0.75, 2.20). Surgical complications occurred in 30% of neoadjuvant chemotherapy recipients and in 31% of adjuvant chemotherapy recipients.

CONCLUSIONS: The current results suggest that patients who receive neoadjuvant chemotherapy are less likely to undergo immediate reconstruction and are no more likely to undergo delayed reconstruction than patients who undergo surgery before they receive chemotherapy.

Author List

Hu YY, Weeks CM, In H, Dodgion CM, Golshan M, Chun YS, Hassett MJ, Corso KA, Gu X, Lipsitz SR, Greenberg CC

Author

Christopher M. Dodgion MD Associate Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Aged
Aged, 80 and over
Antineoplastic Agents
Breast Neoplasms
Chemotherapy, Adjuvant
Female
Humans
Mammaplasty
Mastectomy
Middle Aged
Neoadjuvant Therapy
Neoplasm Staging
Postoperative Complications
Treatment Outcome