Impact of Chemotherapy on Postoperative Complications After Mastectomy and Immediate Breast Reconstruction

Peled, Anne Warren; Itakura, K; Foster, Robert D.; Hamolsky, Deborah; Tanaka, J; Ewing, Cheryl A.; Alvarado, Michael; Esserman, Laura J.; Hwang, E. Shelley

doi:10.1001/archsurg.2010.163

Cited by 119 publications

(61 citation statements)

References 20 publications

(23 reference statements)

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“…However, a study by Decker et al [17] did reveal a trend toward increased wound complications in patients who received NAC and underwent mastectomies with immediate reconstruction, although it was not statistically significant (OR = 1.58; 95% CI = 0.98–2.58). For the 5 studies (n = 765 patients) that reported the influence of NAC on the occurrence of hematomas after surgery [9], [11], [21]–[23], the pooled result showed that there was no statistically significant difference in the incidence of hematomas between the 2 groups (OR = 1.35; 95% CI = 0.57–3.21; Fig. 3).…”

Section: Resultsmentioning

confidence: 98%

“…Of the included reports, 6 studies [9], [18], [20], [21], [23], [28] described reconstruction outcomes including E/I loss during E/I reconstruction and total flap loss during autologous reconstruction. For E/I loss, 4 studies [9], [18], [20], [21] provided mixed results.…”

Section: Resultsmentioning

confidence: 99%

“…For E/I loss, 4 studies [9], [18], [20], [21] provided mixed results. Three studies [9], [20], [21] revealed no NAC-related increase in the risk of E/I loss in women who underwent E/I reconstruction. However, Jiménez-Puente et al [18] observed a markedly elevated E/I loss rate (OR = 5.10, P = 0.004) in women who received NAC (7/13 patients with E/I loss) compared to women who did not receive NAC (19/102 patients).…”

Section: Resultsmentioning

confidence: 99%

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Impact of Neoadjuvant Chemotherapy on Immediate Breast Reconstruction: A Meta-Analysis

et al. 2014

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ObjectiveThe objective of this study was to perform a meta-analysis of published studies for evaluating the impact of neoadjuvant chemotherapy (NAC) on immediate breast reconstruction.MethodsWe searched medical databases to identify appropriate studies that assessed the impact of NAC on immediate breast reconstruction from the inception of this technique through April 2013. We then performed a meta-analysis of these studies.ResultsOur searches identified 11 studies among 1,840 citations. In the meta-analysis, NAC did not increase the overall rate of complications after immediate breast reconstruction (odds ratio [OR] = 0.59; 95% confidence interval[CI] = 0.38–0.91). The complication rate was also unaffected by NAC when we considered infections (OR = 0.82; 95% CI = 0.46–1.45), hematomas (OR = 1.35; 95% CI = 0.57–3.21), and seromas (OR = 0.77; 95% CI = 0.23–2.55). Additionally, expander or implant loss did not significantly increase in patients after NAC (OR = 1.59; 95% CI = 0.91–2.79). Only 2 studies (202 procedures) had reported total autologous flap loss, and they were included in our analysis; both studies found no association between NAC and total flap loss.ConclusionOur analysis suggests that NAC does not increase the complication rate after immediate breast reconstruction. For appropriately selected patients, immediate breast reconstruction following NAC is a safe procedure. The best way to study this issue in the future is to conduct a multicenter prospective study with a longer follow-up period and more clearly defined parameters.

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Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Impact of Neoadjuvant Chemotherapy on Immediate Breast Reconstruction: A Meta-Analysis

et al. 2014

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“…A few studies have attempted to determine the effect of chemotherapy on postoperative breast-implant infection 19,44,48,49. Peled et al analyzed 163 patients who underwent mastectomy and immediate reconstruction, including 66% implant-based and 33% autologous tissue-based reconstructions 48.…”

Section: Risk Factors For Implant Infectionmentioning

confidence: 99%

“…Peled et al analyzed 163 patients who underwent mastectomy and immediate reconstruction, including 66% implant-based and 33% autologous tissue-based reconstructions 48. The adjuvant-chemotherapy group had a significantly higher number of infections (44%) versus the neoadjuvant- and no-chemotherapy groups (23% and 25%, respectively).…”

Section: Risk Factors For Implant Infectionmentioning

confidence: 99%

Reducing infection risk in implant-based breast-reconstruction surgery: challenges and solutions<div><br /></div>

Ooi

Song

2016

BCTT

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Implant-based procedures are the most commonly performed method for postmastectomy breast reconstruction. While donor-site morbidity is low, these procedures are associated with a higher risk of reconstructive loss. Many of these are related to infection of the implant, which can lead to prolonged antibiotic treatment, undesired additional surgical procedures, and unsatisfactory results. This review combines a summary of the recent literature regarding implant-related breast-reconstruction infections and combines this with a practical approach to the patient and surgery aimed at reducing this risk. Prevention of infection begins with appropriate reconstructive choice based on an assessment and optimization of risk factors. These include patient and disease characteristics, such as smoking, obesity, large breast size, and immediate reconstructive procedures, as well as adjuvant therapy, such as radiotherapy and chemotherapy. For implant-based breast reconstruction, preoperative planning and organization is key to reducing infection. A logical and consistent intraoperative and postoperative surgical protocol, including appropriate antibiotic choice, mastectomy-pocket creation, implant handling, and considered acellular dermal matrix use contribute toward the reduction of breast-implant infections.

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Addressing Imaging Pitfalls to Reduce Cardiovascular Disease Misdiagnosis in Patients With Breast Cancer Following Reconstruction

2022

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Impact of Chemotherapy on Postoperative Complications After Mastectomy and Immediate Breast Reconstruction

Cited by 119 publications

References 20 publications

Impact of Neoadjuvant Chemotherapy on Immediate Breast Reconstruction: A Meta-Analysis

Impact of Neoadjuvant Chemotherapy on Immediate Breast Reconstruction: A Meta-Analysis

Reducing infection risk in implant-based breast-reconstruction surgery: challenges and solutions<div><br /></div>

Addressing Imaging Pitfalls to Reduce Cardiovascular Disease Misdiagnosis in Patients With Breast Cancer Following Reconstruction

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