TY - JOUR
T1 - Neoadjuvant therapy and breast cancer surgery
T2 - A closer look at postoperative complications
AU - Garvey, Erin M.
AU - Gray, Richard J.
AU - Wasif, Nabil
AU - Casey, William J.
AU - Rebecca, Alanna M.
AU - Kreymerman, Peter
AU - Bash, Deborah
AU - Pockaj, Barbara A.
N1 - Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.
PY - 2013/12
Y1 - 2013/12
N2 - Background Neoadjuvant therapy is important in the treatment of advanced breast cancer. Methods Postoperative complications in neoadjuvant patients were analyzed. Results One hundred forty patients underwent 148 breast cancer surgeries after neoadjuvant therapy: 28% breast-conserving therapy procedures, 36% mastectomies, 28% mastectomies with immediate reconstruction, and 8% mastectomies with delayed reconstruction. Forty-seven patients (34%) suffered 59 complications: 18% of those undergoing breast-conserving therapy, 30% of those undergoing mastectomy, 44% of those undergoing mastectomy with immediate reconstruction, and 67% of those undergoing mastectomy with delayed reconstruction. Major complications occurred in 18% of patients. Skin loss occurred in 6% of patients. One patient had partial nipple necrosis. Three patients suffered implant loss. One patient had deep inferior epigastric artery perforator flap loss. Eleven hematomas and 5 infectious complications required reoperation. Conclusions Surgery after neoadjuvant therapy is safe, but careful counseling is warranted given that 18% of patients experienced major complications. Complications rates are higher with reconstruction, but feared complications of skin, nipple, implant, or flap loss were infrequent.
AB - Background Neoadjuvant therapy is important in the treatment of advanced breast cancer. Methods Postoperative complications in neoadjuvant patients were analyzed. Results One hundred forty patients underwent 148 breast cancer surgeries after neoadjuvant therapy: 28% breast-conserving therapy procedures, 36% mastectomies, 28% mastectomies with immediate reconstruction, and 8% mastectomies with delayed reconstruction. Forty-seven patients (34%) suffered 59 complications: 18% of those undergoing breast-conserving therapy, 30% of those undergoing mastectomy, 44% of those undergoing mastectomy with immediate reconstruction, and 67% of those undergoing mastectomy with delayed reconstruction. Major complications occurred in 18% of patients. Skin loss occurred in 6% of patients. One patient had partial nipple necrosis. Three patients suffered implant loss. One patient had deep inferior epigastric artery perforator flap loss. Eleven hematomas and 5 infectious complications required reoperation. Conclusions Surgery after neoadjuvant therapy is safe, but careful counseling is warranted given that 18% of patients experienced major complications. Complications rates are higher with reconstruction, but feared complications of skin, nipple, implant, or flap loss were infrequent.
KW - Breast cancer surgery
KW - Neoadjuvant
KW - Postoperative complications
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U2 - 10.1016/j.amjsurg.2013.09.004
DO - 10.1016/j.amjsurg.2013.09.004
M3 - Article
C2 - 24296095
AN - SCOPUS:84889033537
SN - 0002-9610
VL - 206
SP - 894
EP - 899
JO - American journal of surgery
JF - American journal of surgery
IS - 6
ER -