The Impact of neoadjuvant chemotherapy on postoperative complications in breast cancer surgery

Aim The aim of this study is to demonstrate that nowadays neoadjuvant systemic treatment has no negative impact on different types of oncoplastic and conventional breast cancer surgeries.

Material und Methods Retrospective analysis from a prospectively maintained database. We will compare patients with and without neoadjuvant systemic treatment, as well as different subgroups according to the surgical procedure (conventional breast conserving surgery with different oncoplastic procedures). Evaluation of wound healing and postoperative complications, as well as established risk factors like diabetes and smoking.

Results Among 549 patients with breast cancer, 65 (11.8 %) received neoadjuvant systemic treatment, while 476 (88.2 %) underwent a primary surgery. In comparison, both groups showed no significant difference relating to postoperative infections, necrosis, seroma, lymphedema, axillary web syndrome and chronic pain.

Summary Nowadays neoadjuvant systemic treatment is regarded as the standard of care for stage II-III, HER2-positive or triple negative breast cancer patients in order to enable de-escalation of surgical treatment and to observe how well the cancer responds to the treatment. There has been concern though that it may increase postoperative complications. As a result, these complications may delay the commencement of adjuvant radiotherapy. Since postoperative complications were believed to be increased after neoadjuvant systemic treatment, surgical treatment of breast cancer is usually scheduled not earlier than three weeks after the last chemotherapy. Systemic treatment regimens have evolved over the last decades with often less toxicity. This calls for a better understanding of the actual impact of modern neoadjuvant systemic treatment on surgical outcomes.

Publikationsverlauf

Artikel online veröffentlicht:
01. Juni 2021