Abstract QS24: Outcomes in Patients Receiving Neoadjuvant Chemotherapy Undergoing Immediate Breast Reconstruction: Effect of Timing and Postoperative Complications
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Abstract
PURPOSE: The impact of neoadjuvant chemotherapy on postoperative complications is
important in breast cancer patients undergoing immediate breast reconstruction since
it has the potential to delay adjuvant radiation therapy. This study was conducted
to examine the effect of time from last dose of neoadjuvant chemotherapy to immediate
breast reconstruction on postoperative complications and to assess if postoperative
complications cause any delay in commencement of radiation treatment.
METHODS: A retrospective review was performed on patients who underwent neoadjuvant
chemotherapy with immediate breast reconstruction using tissue expanders from November
2011 to May 2017 in a NCI designated academic cancer center. The time interval from
the last dose of chemotherapy to surgery was calculated for all patients. Patients
who underwent radiation treatment had the time interval from surgery to commencement
of radiation treatment calculated. Postoperative surgical complications were categorized
as either major or minor complications depending on whether patients required hospitalization
or reoperation. Independent sample t-tests were used to compare means for both time
to surgery from first dose of chemotherapy therapy and time to commencement of radiation
between patients with major complications and minor complications versus those with
no complications. Descriptive statistics were used to summarize patient demographics
and characteristics.
RESULTS: A total of 128 patients were identified. Mean time to surgery from last dose
of chemotherapy was 31.81 days with a range of 12–89 days. Of the 128 patients, 25
(19.5%) experienced a major complication necessitating hospitalization or return to
the O.R., and 50 (39.1%) experienced any minor complication. Out of the 128 patients,
54 patients completed radiation therapy at our institution. The mean time to commencement
of radiation from surgery was 70.74 days with a range of 24–178 days. The difference
in time to commencement of radiation between patients with major complications and
no complications was statistically significant (p=0.018), and the difference in time
to commencement of radiation between patients with minor complications and no complications
was also statistically significant (p=0.027). For patients who experienced any major
complication, there was no statistical significance (p = 0.835) for time to surgery
from last chemotherapy dose when compared with patients with no major complications.
In addition, there was no statistical significance (p=0.710) for time to surgery from
last dose of chemotherapy when comparing patients with minor complications and no
minor complications.
CONCLUSION: Postoperative major and minor complications delay the commencement of
radiation in patients who undergo neoadjuvant chemotherapy with immediate breast reconstruction
compared to patients with no complications. However, the time period from last dose
of chemotherapy to immediate breast reconstruction surgery does not appear to contribute
to postoperative major or minor complications. These findings are important when counseling
patients who desire immediate breast reconstruction with tissue expanders.
C.J. Venutolo: None. M. Cho: None. A. Hembd: None. S. Hampton: None. A.P. Jayaraman:
None. N.T. Haddock: None. S.S. Teotia: None.
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