Impact of neoadjuvant chemotherapy on breast reconstruction

Yue Yung Hu, Christine M. Weeks, Haejin In, Christopher M. Dodgion, Mehra Golshan, Yoon S. Chun, Michael J. Hassett, Katherine A. Corso, Xiangmei Gu, Stuart R. Lipsitz, Caprice C. Greenberg

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

BACKGROUND: With advances in oncologic treatment, cosmesis after mastectomy has assumed a pivotal role in patient and provider decision making. Multiple studies have confirmed the safety of both chemotherapy before breast surgery and immediate reconstruction. Little has been written about the effect of neoadjuvant chemotherapy on decisions about reconstruction. METHODS: The authors identified 665 patients with stage I through III breast cancer who received chemotherapy and underwent mastectomy at Dana-Farber/Brigham & Women's Cancer Center from 1997 to 2007. By using multivariate logistic regression, reconstruction rates were compared between patients who received neoadjuvant chemotherapy (n = 180) and patients who underwent mastectomy before chemotherapy (n = 485). The rate of postoperative complications after mastectomy was determined for patients who received neoadjuvant chemotherapy compared with those who did not. RESULTS: Reconstruction was performed immediately in 44% of patients who did not receive neoadjuvant chemotherapy but in only 23% of those who did. Twenty-one percent of neoadjuvant chemotherapy recipients and 14% of adjuvant-only chemotherapy recipients underwent delayed reconstruction. After controlling for age, receipt of radiotherapy, and disease stage, neoadjuvant recipients were less likely to undergo immediate reconstruction (odds ratio [OR], 0.57; 95% confidence interval [CI], 0.37, 0.87) but were no more likely to undergo delayed reconstruction (OR, 1.29; 95% CI, 0.75, 2.20). Surgical complications occurred in 30% of neoadjuvant chemotherapy recipients and in 31% of adjuvant chemotherapy recipients. CONCLUSIONS: The current results suggest that patients who receive neoadjuvant chemotherapy are less likely to undergo immediate reconstruction and are no more likely to undergo delayed reconstruction than patients who undergo surgery before they receive chemotherapy.

Original languageEnglish (US)
Pages (from-to)2833-2841
Number of pages9
JournalCancer
Volume117
Issue number13
DOIs
StatePublished - Jul 1 2011
Externally publishedYes

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Mammaplasty
Drug Therapy
Mastectomy
Adjuvant Chemotherapy
Odds Ratio
Confidence Intervals
Decision Making
Breast
Radiotherapy
Logistic Models
Breast Neoplasms
Safety

Keywords

  • breast cancer
  • breast reconstruction
  • mastectomy
  • neoadjuvant chemotherapy
  • postoperative complications

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Hu, Y. Y., Weeks, C. M., In, H., Dodgion, C. M., Golshan, M., Chun, Y. S., ... Greenberg, C. C. (2011). Impact of neoadjuvant chemotherapy on breast reconstruction. Cancer, 117(13), 2833-2841. https://doi.org/10.1002/cncr.25872

Impact of neoadjuvant chemotherapy on breast reconstruction. / Hu, Yue Yung; Weeks, Christine M.; In, Haejin; Dodgion, Christopher M.; Golshan, Mehra; Chun, Yoon S.; Hassett, Michael J.; Corso, Katherine A.; Gu, Xiangmei; Lipsitz, Stuart R.; Greenberg, Caprice C.

In: Cancer, Vol. 117, No. 13, 01.07.2011, p. 2833-2841.

Research output: Contribution to journalArticle

Hu, YY, Weeks, CM, In, H, Dodgion, CM, Golshan, M, Chun, YS, Hassett, MJ, Corso, KA, Gu, X, Lipsitz, SR & Greenberg, CC 2011, 'Impact of neoadjuvant chemotherapy on breast reconstruction', Cancer, vol. 117, no. 13, pp. 2833-2841. https://doi.org/10.1002/cncr.25872
Hu YY, Weeks CM, In H, Dodgion CM, Golshan M, Chun YS et al. Impact of neoadjuvant chemotherapy on breast reconstruction. Cancer. 2011 Jul 1;117(13):2833-2841. https://doi.org/10.1002/cncr.25872
Hu, Yue Yung ; Weeks, Christine M. ; In, Haejin ; Dodgion, Christopher M. ; Golshan, Mehra ; Chun, Yoon S. ; Hassett, Michael J. ; Corso, Katherine A. ; Gu, Xiangmei ; Lipsitz, Stuart R. ; Greenberg, Caprice C. / Impact of neoadjuvant chemotherapy on breast reconstruction. In: Cancer. 2011 ; Vol. 117, No. 13. pp. 2833-2841.
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title = "Impact of neoadjuvant chemotherapy on breast reconstruction",
abstract = "BACKGROUND: With advances in oncologic treatment, cosmesis after mastectomy has assumed a pivotal role in patient and provider decision making. Multiple studies have confirmed the safety of both chemotherapy before breast surgery and immediate reconstruction. Little has been written about the effect of neoadjuvant chemotherapy on decisions about reconstruction. METHODS: The authors identified 665 patients with stage I through III breast cancer who received chemotherapy and underwent mastectomy at Dana-Farber/Brigham & Women's Cancer Center from 1997 to 2007. By using multivariate logistic regression, reconstruction rates were compared between patients who received neoadjuvant chemotherapy (n = 180) and patients who underwent mastectomy before chemotherapy (n = 485). The rate of postoperative complications after mastectomy was determined for patients who received neoadjuvant chemotherapy compared with those who did not. RESULTS: Reconstruction was performed immediately in 44{\%} of patients who did not receive neoadjuvant chemotherapy but in only 23{\%} of those who did. Twenty-one percent of neoadjuvant chemotherapy recipients and 14{\%} of adjuvant-only chemotherapy recipients underwent delayed reconstruction. After controlling for age, receipt of radiotherapy, and disease stage, neoadjuvant recipients were less likely to undergo immediate reconstruction (odds ratio [OR], 0.57; 95{\%} confidence interval [CI], 0.37, 0.87) but were no more likely to undergo delayed reconstruction (OR, 1.29; 95{\%} CI, 0.75, 2.20). Surgical complications occurred in 30{\%} of neoadjuvant chemotherapy recipients and in 31{\%} of adjuvant chemotherapy recipients. CONCLUSIONS: The current results suggest that patients who receive neoadjuvant chemotherapy are less likely to undergo immediate reconstruction and are no more likely to undergo delayed reconstruction than patients who undergo surgery before they receive chemotherapy.",
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T1 - Impact of neoadjuvant chemotherapy on breast reconstruction

AU - Hu, Yue Yung

AU - Weeks, Christine M.

AU - In, Haejin

AU - Dodgion, Christopher M.

AU - Golshan, Mehra

AU - Chun, Yoon S.

AU - Hassett, Michael J.

AU - Corso, Katherine A.

AU - Gu, Xiangmei

AU - Lipsitz, Stuart R.

AU - Greenberg, Caprice C.

PY - 2011/7/1

Y1 - 2011/7/1

N2 - BACKGROUND: With advances in oncologic treatment, cosmesis after mastectomy has assumed a pivotal role in patient and provider decision making. Multiple studies have confirmed the safety of both chemotherapy before breast surgery and immediate reconstruction. Little has been written about the effect of neoadjuvant chemotherapy on decisions about reconstruction. METHODS: The authors identified 665 patients with stage I through III breast cancer who received chemotherapy and underwent mastectomy at Dana-Farber/Brigham & Women's Cancer Center from 1997 to 2007. By using multivariate logistic regression, reconstruction rates were compared between patients who received neoadjuvant chemotherapy (n = 180) and patients who underwent mastectomy before chemotherapy (n = 485). The rate of postoperative complications after mastectomy was determined for patients who received neoadjuvant chemotherapy compared with those who did not. RESULTS: Reconstruction was performed immediately in 44% of patients who did not receive neoadjuvant chemotherapy but in only 23% of those who did. Twenty-one percent of neoadjuvant chemotherapy recipients and 14% of adjuvant-only chemotherapy recipients underwent delayed reconstruction. After controlling for age, receipt of radiotherapy, and disease stage, neoadjuvant recipients were less likely to undergo immediate reconstruction (odds ratio [OR], 0.57; 95% confidence interval [CI], 0.37, 0.87) but were no more likely to undergo delayed reconstruction (OR, 1.29; 95% CI, 0.75, 2.20). Surgical complications occurred in 30% of neoadjuvant chemotherapy recipients and in 31% of adjuvant chemotherapy recipients. CONCLUSIONS: The current results suggest that patients who receive neoadjuvant chemotherapy are less likely to undergo immediate reconstruction and are no more likely to undergo delayed reconstruction than patients who undergo surgery before they receive chemotherapy.

AB - BACKGROUND: With advances in oncologic treatment, cosmesis after mastectomy has assumed a pivotal role in patient and provider decision making. Multiple studies have confirmed the safety of both chemotherapy before breast surgery and immediate reconstruction. Little has been written about the effect of neoadjuvant chemotherapy on decisions about reconstruction. METHODS: The authors identified 665 patients with stage I through III breast cancer who received chemotherapy and underwent mastectomy at Dana-Farber/Brigham & Women's Cancer Center from 1997 to 2007. By using multivariate logistic regression, reconstruction rates were compared between patients who received neoadjuvant chemotherapy (n = 180) and patients who underwent mastectomy before chemotherapy (n = 485). The rate of postoperative complications after mastectomy was determined for patients who received neoadjuvant chemotherapy compared with those who did not. RESULTS: Reconstruction was performed immediately in 44% of patients who did not receive neoadjuvant chemotherapy but in only 23% of those who did. Twenty-one percent of neoadjuvant chemotherapy recipients and 14% of adjuvant-only chemotherapy recipients underwent delayed reconstruction. After controlling for age, receipt of radiotherapy, and disease stage, neoadjuvant recipients were less likely to undergo immediate reconstruction (odds ratio [OR], 0.57; 95% confidence interval [CI], 0.37, 0.87) but were no more likely to undergo delayed reconstruction (OR, 1.29; 95% CI, 0.75, 2.20). Surgical complications occurred in 30% of neoadjuvant chemotherapy recipients and in 31% of adjuvant chemotherapy recipients. CONCLUSIONS: The current results suggest that patients who receive neoadjuvant chemotherapy are less likely to undergo immediate reconstruction and are no more likely to undergo delayed reconstruction than patients who undergo surgery before they receive chemotherapy.

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KW - mastectomy

KW - neoadjuvant chemotherapy

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