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29.04.2019 | Breast Oncology | Ausgabe 9/2019

Annals of Surgical Oncology 9/2019

Neoadjuvant Chemotherapy does not Increase Complications in Oncoplastic Breast-Conserving Surgery

Zeitschrift:
Annals of Surgical Oncology > Ausgabe 9/2019
Autoren:
MD Karri Adamson, MD, MSc Mariana Chavez-MacGregor, MD, MS, CMQ, FACS Abigail Caudle, MD Benjamin Smith, MD, FACS Donald Baumann, PhD Jun Liu, MB ChB, MD, MSc, MEd, FRCS(Plast) Mark Schaverien
Wichtige Hinweise
Presented at the American Society for Reconstructive Microsurgery annual meeting, Palm Desert, CA, February 1–5, 2019.

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Abstract

Background

Oncoplastic breast-conserving surgery (OBCS) broadens the indications for breast conservation. Neoadjuvant systemic chemotherapy (NAC) is used increasingly in the treatment of patients with early-stage and locally advanced breast cancer. This study aimed to evaluate the outcomes for patients who received NAC followed by OBCS.

Methods

A retrospective chart review was performed for all patients who underwent OBCS involving the mastopexy/breast-reduction technique, including synchronous mastopexy/breast reduction for symmetry, at the University of Texas MD Anderson Cancer Center between January 2010 and January 2016. Patients who had received NAC were compared with those who had undergone surgery first. Demographic, treatment, and outcomes data were collected.

Results

The study included 429 patients, corresponding to 713 breasts. Of these patients, 122, corresponding to 199 breasts, received NAC. The patients who received NAC were younger (p < 0.001) and had a more advanced cancer stage (p < 0.001). The overall complication rate per patient was 25.9%, with major complications occurring in 9.1% of the patients. After adjustment for risk factors, NAC was not shown to be associated with an increased risk of complications or delayed adjuvant radiation therapy (p = 0.37), irrespective of the chemotherapy regimen used or whether the interval between NAC and surgery was 4 weeks or longer.

Conclusions

In a high-volume center, OBCS can be performed safely for carefully selected patients after NAC without an increased risk of complications or delayed adjuvant radiation therapy. An interval of at least 4 weeks between completion of NAC and surgery can be regarded as safe irrespective of the chemotherapy regimen used.

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