Immediate reconstruction after mastectomy does not delay chemotherapy

Breast reconstruction can be performed at the time of mastectomy for breast cancer without delaying the initiation of adjuvant chemotherapy, new research indicates. However, this approach is associated with an increased rate of wound complications.

Immediate breast reconstruction (IBR) is growing in popularity because it has been shown to improve psychosocial well-being and self-image, senior author Dr. Richard J. Bold and colleagues, from UC Davis Medical Center in Sacramento, California, note. However, this approach may increase the risk of wound complications, which could in turn delay the initiation of chemotherapy, possibly having an adverse effect on recurrence or survival.To investigate, the researchers analyzed data from 128 women with breast cancer who underwent a total of 148 mastectomies at their center. The subjects included 62 who underwent IBR and 66 who did not, according to the report in the Archives of Surgery for September.Contrary to the investigator’s hypothesis, IBR did, in fact, increase the risk of wound complications. Seventeen of 76 procedures (22.3%) in the IBR group involved a wound infection compared with just 6 of 72 procedures (8.3%) among controls (p = 0.02).Despite the increased rate of wound complications, IBR did not delay the initiation of adjuvant chemotherapy. Just two patients in each group received adjuvant chemotherapy later than 4 to 6 weeks postoperatively, the window when most oncologists prefer to begin such therapy.The results reinforce the message that “anticipated administration of adjuvant chemotherapy should not deter the use of IBR performed in conjunction with a mastectomy for breast cancer,” the authors emphasize.(Source: Arch Surg 2004;139:988-991: Reuters Health News: Oncolink: September 2004.)