Neoadjuvant therapy and breast cancer surgery: A closer look at postoperative complications

Erin M. Garvey, Richard J. Gray, Nabil Wasif, William J. Casey, Alanna M. Rebecca, Peter Kreymerman, Deborah Bash, Barbara A. Pockaj

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)894-899
Number of pages6
JournalAmerican journal of surgery
Volume206
Issue number6
DOIs
StatePublished - Dec 1 2013

Keywords

  • Breast cancer surgery
  • Neoadjuvant
  • Postoperative complications

ASJC Scopus subject areas

  • Surgery

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