Does Chemotherapy or Radiotherapy Affect the Postoperative Complication in Breast Cancer Patients Who Underwent Immediate Breast Reconstruction with Tissue Expander?

Overview

Journal BMC Cancer

Publisher Biomed Central

Specialty Oncology

Date 2021 Jan 23

PMID 33482758

Citations 5

Authors

Sung Mi Jung

Byung-Joon Jeon

Jinsun Woo

Jai Min Ryu

Se Kyung Lee

Byung-Joo Chae

Jonghan Yu

Seok Won Kim

Seok Jin Nam

Jai-Kyong Pyon

Goo-Hyun Mun

Sa Ik Bang

Jeong Eon Lee

Affiliations

Soon will be listed here.

Abstract

Background: Immediate breast reconstruction with tissue expander in breast cancer patients who were expected to receive adjuvant therapy, such as chemotherapy or radiotherapy, has been a topic of debate. Postoperative complications from tissue expander procedures can delay the timing of adjuvant treatment and subsequently increase the probability of recurrence. The purpose of this study was to identify the impact of chemotherapy and radiotherapy on postoperative complications in patients who underwent immediate reconstruction (IR) using tissue expander.

Methods: We conducted a retrospective study of 1081 breast cancer patients who underwent mastectomy and IR using tissue expander insertion between 2012 and 2017 in Samsung Medical Center. The patients were divided into two groups based on complications (complication group vs. no complication group). Complication group was regarded to have surgical removal or conservative treatment based on clinical findings such as infection, capsular contracture, seroma, hematoma, rupture, malposition, tissue viability, or cosmetic problem. The complication group had 59 patients (5.5%) and the no complication group had 1022 patients (94.5%).

Results: In univariate analysis, adjuvant radiotherapy and adjuvant chemotherapy were significantly associated with postoperative complications. In multivariate analysis, however, only higher pathologic N stage was significantly associated with postoperative complications (p < 0.001). Chemotherapy (p = 0.775) or radiotherapy (p = 0.825) were not risk factors for postoperative complications.

Conclusions: IR with tissue expander after mastectomy may be a treatment option even when the patients are expected to receive adjuvant chemotherapy or radiotherapy. These results will aid patients who are concerned about the complications of IR caused by chemotherapy or radiotherapy determine whether or not to have IR.

Trial Registration: Patients were selected and registered retrospectively, and medical records were evaluated.

Citing Articles

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The Impact of Nasal Staphylococcus aureus Carriage on Surgical-Site Infections after Immediate Breast Reconstruction: Risk Factors and Biofilm Formation Potential.

Szymankiewicz M, Jarzynka S, Koryszewska-Baginska A, Nowikiewicz T Med Sci Monit. 2023; 29:e940898.

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Breast reconstruction during the COVID-19 pandemic in resource-limited settings.

Al-Benna S, Gohritz A GMS Interdiscip Plast Reconstr Surg DGPW. 2021; 10:Doc10.

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References

Ryu J, Paik H, Park S, Yi H, Nam S, Kim S . Oncologic Outcomes after Immediate Breast Reconstruction Following Total Mastectomy in Patients with Breast Cancer: A Matched Case-Control Study. J Breast Cancer. 2017; 20(1):74-81. PMC: 5378582. DOI: 10.4048/jbc.2017.20.1.74. View

Ten Wolde B, van den Wildenberg F, Keemers-Gels M, Polat F, Strobbe L . Quilting prevents seroma formation following breast cancer surgery: closing the dead space by quilting prevents seroma following axillary lymph node dissection and mastectomy. Ann Surg Oncol. 2013; 21(3):802-7. DOI: 10.1245/s10434-013-3359-x. View

Sada A, Day C, Hoskin T, Degnim A, Habermann E, Hieken T . Mastectomy and immediate breast reconstruction in the elderly: Trends and outcomes. Surgery. 2019; 166(4):709-714. DOI: 10.1016/j.surg.2019.05.055. View

Sekiguchi K, Kawamori J, Yamauchi H . Breast reconstruction and postmastectomy radiotherapy: complications by type and timing and other problems in radiation oncology. Breast Cancer. 2017; 24(4):511-520. DOI: 10.1007/s12282-017-0754-3. View

Lee S, Park C, Lee J, Kim S, Kwon P, Kim W . Generation of pure lymphatic endothelial cells from human pluripotent stem cells and their therapeutic effects on wound repair. Sci Rep. 2015; 5:11019. PMC: 4464258. DOI: 10.1038/srep11019. View

Song J, Zhang X, Liu Q, Peng J, Liang X, Shen Y . Impact of neoadjuvant chemotherapy on immediate breast reconstruction: a meta-analysis. PLoS One. 2014; 9(5):e98225. PMC: 4039499. DOI: 10.1371/journal.pone.0098225. View

Dolen U, Schmidt A, Um G, Sharma K, Naughton M, Zoberi I . Impact of Neoadjuvant and Adjuvant Chemotherapy on Immediate Tissue Expander Breast Reconstruction. Ann Surg Oncol. 2016; 23(7):2357-66. DOI: 10.1245/s10434-016-5162-y. View

Furey P, MacGILLIVRAY D, Castiglione C, Allen L . Wound complications in patients receiving adjuvant chemotherapy after mastectomy and immediate breast reconstruction for breast cancer. J Surg Oncol. 1994; 55(3):194-7. DOI: 10.1002/jso.2930550313. View

Cemal Y, Albornoz C, Disa J, McCarthy C, Mehrara B, Pusic A . A paradigm shift in U.S. breast reconstruction: Part 2. The influence of changing mastectomy patterns on reconstructive rate and method. Plast Reconstr Surg. 2013; 131(3):320e-326e. DOI: 10.1097/PRS.0b013e31827cf576. View

10.

Heimes A, Stewen K, Hasenburg A . Psychosocial Aspects of Immediate versus Delayed Breast Reconstruction. Breast Care (Basel). 2018; 12(6):374-377. PMC: 5803679. DOI: 10.1159/000485234. View

11.

Killelea B, Long J, Dang W, Mougalian S, Evans S, Gross C . Associations Between Sentinel Lymph Node Biopsy and Complications for Patients with Ductal Carcinoma In Situ. Ann Surg Oncol. 2018; 25(6):1521-1529. PMC: 5928184. DOI: 10.1245/s10434-018-6410-0. View

12.

Yoon A, Qi J, Brown D, Kim H, Hamill J, Erdmann-Sager J . Outcomes of immediate versus delayed breast reconstruction: Results of a multicenter prospective study. Breast. 2017; 37:72-79. PMC: 5902735. DOI: 10.1016/j.breast.2017.10.009. View

13.

Lee S, Lee J, Son B, Eom J, Kim E, Lee T . Oncologic safety of skin-sparing mastectomy followed by immediate reconstruction in young patients with breast cancer. Asian J Surg. 2018; 42(1):274-282. DOI: 10.1016/j.asjsur.2018.04.004. View

14.

Coveney E, ODwyer P, Geraghty J, OHiggins N . Effect of closing dead space on seroma formation after mastectomy--a prospective randomized clinical trial. Eur J Surg Oncol. 1993; 19(2):143-6. View

15.

Recai Unalp H, Onal M . Analysis of risk factors affecting the development of seromas following breast cancer surgeries: seromas following breast cancer surgeries. Breast J. 2007; 13(6):588-92. DOI: 10.1111/j.1524-4741.2007.00509.x. View

16.

Mitchem J, Herrmann D, Margenthaler J, Aft R . Impact of neoadjuvant chemotherapy on rate of tissue expander/implant loss and progression to successful breast reconstruction following mastectomy. Am J Surg. 2008; 196(4):519-22. DOI: 10.1016/j.amjsurg.2008.06.016. View

17.

Allue Cabanuz M, Arribas Del Amo M, Gil Romea I, Val-Carreres Rivera M, Sousa Dominguez R, Guemes Sanchez A . Direct-to-implant breast reconstruction after neoadjuvant chemotherapy: A safe option?. Cir Esp (Engl Ed). 2019; 97(10):575-581. DOI: 10.1016/j.ciresp.2019.07.003. View

18.

Boostrom S, Throckmorton A, Boughey J, Holifield A, Zakaria S, Hoskin T . Incidence of clinically significant seroma after breast and axillary surgery. J Am Coll Surg. 2009; 208(1):148-50. DOI: 10.1016/j.jamcollsurg.2008.08.029. View

19.

Lam T, Borotkanics R, Hsieh F, Salinas J, Boyages J . Immediate Two-Stage Prosthetic Breast Reconstruction Failure: Radiation Is Not the Only Culprit. Plast Reconstr Surg. 2018; 141(6):1315-1324. DOI: 10.1097/PRS.0000000000004358. View

20.

Garvey P, Villa M, Rozanski A, Liu J, Robb G, Beahm E . The advantages of free abdominal-based flaps over implants for breast reconstruction in obese patients. Plast Reconstr Surg. 2012; 130(5):991-1000. PMC: 3749735. DOI: 10.1097/PRS.0b013e318267efc5. View