Does chemotherapy or radiotherapy affect the postoperative complication in breast cancer patients who underwent immediate breast reconstruction with tissue expander?

Sung Mi Jung,Sa Ik Bang,Jai-Kyong Pyon,Seok Jin Nam,Jinsun Woo,Byung-Joo Chae,Jai Min Ryu,Jonghan Yu,Seok Won Kim,Jeong Eon Lee,Goo-Hyun Mun,Se Kyung Lee,Byung-Joon Jeon

doi:10.1186/s12885-020-07729-w

Sung Mi Jung, Sa Ik Bang + Show 11 more

Open Access

https://doi.org/10.1186/s12885-020-07729-w

Copy DOI

Journal: BMC Cancer	Publication Date: Jan 22, 2021
Citations: 8	License type: open-access

Affiliation: Samsung Medical Center, Sungkyunkwan University

Abstract

BackgroundImmediate 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.MethodsWe 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%).ResultsIn 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.ConclusionsIR 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 registrationPatients were selected and registered retrospectively, and medical records were evaluated.

Highlights

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
DCIS Ductal carcinoma in situ, lymphovascular invasion (LVI) Lymphovasvular invasion, no residual tumor (NRT) No residual tumor, SLNB Sentinel lymph node biopsy, axillary lymph node dissection (ALND) Axillary lymph node dissection, post-mastectomy radiotherapy (PMRT) Post-mastectomy radiotherapy, NAC Neoadjuvant chemotherapy doxorubicin, cyclophosphamide, and docetaxel regimen (AC-D) had 3.304 times the risk of postoperative complications (Table 6)
This study reported that chemotherapy or radiotherapy did not affect postoperative complications in the patients who underwent immediate breast reconstruction with tissue expander

Summary

Introduction

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. Breast cancer is the second most common cancer among women in the United States. In the United States, 250,520 new cases of female breast cancer were reported, and 42,000 women died of this cancer in 2017. For every 100,000 women, 125 new female breast cancer cases were reported and 20 women died of this cancer. Immediate breast reconstruction can provide patients with the opportunity to reduce one additional surgery and costs instead of undergoing two separate procedures [3,4,5,6,7]

Objectives

Methods

Results

Discussion

Conclusion