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.
