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• W2321406586 abstract "Introduction: Neoadjuvant chemotherapy has been shown to be as effective as adjuvant therapy for the treatment of resectable breast cancer, with the advantages of monitoring the in situ tumor for response to therapy and the potential to convert from mastectomy to breast conserving surgery. As a result, the indications for neoadjuvant chemotherapy are expanding. However, limited data are available regarding the impact of neoadjuvant chemotherapy on the risk of post-operative wound complications. Our multi-institutional study addresses this gap. We hypothesized that neoadjuvant chemotherapy would not be associated with an increased risk of wound complication, regardless of type of breast procedure. Methods: Using the American College of Surgeons National Surgical Quality Improvement Program database, we selected patients with a diagnosis of malignant neoplasm of the breast, ductal carcinoma in situ, breast mass, or inflammatory breast disease who underwent 1) breast conserving surgery with lymph node biopsy or dissection 2) mastectomy or 3) mastectomy with immediate or delayed - immediate reconstruction from 2005 – 2009. We performed a stratified analysis of post-operative wound complication (surgical site infection and dehiscence) rates for each of the three surgical groups. Multivariable logistic regression was used to adjust for other risk factors for wound complication, including demographics and pre-operative characteristics. Our primary variable of interest was chemotherapy 30 days prior to surgery. Results: A cohort of 42,088 women with non-metastatic breast cancer who underwent surgery was identified. of these, 1550 (3.7%) received chemotherapy 30 days prior to surgery. the wound complication rate for recipients of neoadjuvant chemotherapy was 3.5%, compared to 2.9% for the remainder of the cohort (p = 0.19). After adjusting for other pre-operative and operative factors, neoadjuvant chemotherapy was not significantly associated with increased risk for wound complication for the cohort as a whole (OR = 1.03, 95% CI 0.76 - 1.38), or when the analysis was stratified by breast procedure. Risk factors that were associated with wound complication included smoking, dependent functional status, overweight and obesity, diabetes, hypertension, mastectomy (with or without reconstruction), and sentinel lymph node biopsy (Table). Conclusions: in this multi-institutional analysis, neoadjuvant chemotherapy was not associated with post-operative wound complication, regardless of the type of breast surgery performed. Patients and providers can be assured that receipt of neoadjuvant therapy does not increase the risk of post-operative wound complication. TableMultivariable Model of Pre-Operative and Operative Factors Predictive of 30-Day Wound Complications in Women Who Underwent Surgical Treatment of Breast Cancer Characteristic Adjusted OR 95% CI P Neoadjuvant chemotherapy 1.03 0.76 – 1.38 0.863 Age 1.00 0.99 – 1.00 0.061 Race: White Referent Race: Black 0.85 0.70 – 1.02 0.377 Race: Other 0.86 0.69 – 1.08 0.590 Smoker 1.67 1.44 – 1.94 <0.001 Partially or fully dependent 1.92 1.35 – 2.72 <0.001 Overweight or obese 1.99 1.72 – 2.30 <0.001 Diabetes 1.55 1.31 – 1.83 <0.001 Hypertension 1.29 1.12 – 1.48 <0.001 Surgical procedure: Breast-conserving surgery Referent Mastectomy 2.23 1.91 – 2.61 <0.001 Mastectomy & reconstruction 2.69 2.26 – 3.20 <0.001 Axillary lymph node dissection 1.10 0.96 – 1.27 0.180 Sentinel lymph node biopsy 1.15 1.01 – 1.30 0.034 OR, odds ratio; CI, confidence interval Open table in a new tab OR, odds ratio; CI, confidence interval" @default.
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• W2321406586 date "2012-02-01" @default.
• W2321406586 modified "2023-09-23" @default.
• W2321406586 title "The Impact of Neoadjuvant Chemotherapy on Wound Complication Risk After Breast Cancer Resection and Reconstruction - A Multi-Institutional Assessment" @default.
• W2321406586 doi "https://doi.org/10.1016/j.jss.2011.11.341" @default.
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