In the November 2019 issue of Plastic & Reconstructive Surgery Journal, there was an article on outcomes in patients who get chemotherapy and then get immediate breast reconstruction. This is an important topic for patients who get breast cancer when they are younger (in their 40s), or get aggressive cancers. These women need to get chemotherapy before they have surgical treatments. So what can science tell us about how to optimize all these factors? We need to try to decrease the tumor burden (hence the pre surgery chemo). We want to remove the cancer (the surgery). Many times we want to reconstruct the breast (especially since many of these women are young). And we need to do further treatments after the surgery, as these tumors were aggressive and high risk. We need to make sure your surgery has healed though, before we can do chemo and radiation again. Can we figure out if there are patients at higher risk? Who are they? What can we do?
So.
“Outcomes in Patients Receiving Neoadjuvant Chemotherapy Undergoing Immediate Breast Reconstruction: Effect of Timing, Postoperative Complications, and Delay to Radiation Therapy.”
Study:
- Retrospective
- 128 patients
- Chemo prior to surgery. Then immediate reconstruction with tissue expander.
Findings?
- Patients who had a complication had a statistically significant difference to when they could start radiation therapy.
- higher BMI showed an association with post operative complications
- No difference in timing of neoadjuvant chemo
Thoughts?
Higher BMI is associated with higher complications for almost all surgeries. If you have a high BMI, this study would support delaying your reconstruction. As it is a retrospective study, it is not iron tight. But statistically significant is significant.