Impact of neoadjuvant chemotherapy on the safety and long-term outcomes of patients undergoing immediate breast reconstruction after mastectomy

• Published in: Breast cancer (Tokyo, Japan) Japan), 2024-05, Vol.31 (3), p.507-518
• Main Authors: Nogi, Hiroko, Ogiya, Akiko, Ishitobi, Makoto, Yamauchi, Chikako, Mori, Hiroki, Shimo, Ayaka, Narui, Kazutaka, Nagura, Naomi, Seki, Hirohito, Sasada, Shinsuke, Sakurai, Teruhisa, Shien, Tadahiko
• Format: Article
• Language: English
• Subjects: Adult; Aged; Breast Neoplasms - drug therapy; Breast Neoplasms - mortality; Breast Neoplasms - pathology; Breast Neoplasms - surgery; Cancer Research; Chemotherapy, Adjuvant - adverse effects; Chemotherapy, Adjuvant - methods; Disease-Free Survival; Female; Follow-Up Studies; Humans; Mammaplasty - adverse effects; Mammaplasty - methods; Mastectomy - adverse effects; Medicine; Medicine & Public Health; Middle Aged; Neoadjuvant Therapy - adverse effects; Neoadjuvant Therapy - methods; Neoplasm Recurrence, Local; Oncology; Original Article; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Propensity Score; Retrospective Studies; Surgery; Surgical Oncology; Treatment Outcome
• ISSN: 1340-6868; 1880-4233
• DOI: 10.1007/s12282-024-01570-w

Background In breast cancer patients receiving neoadjuvant chemotherapy (NAC), immediate breast reconstruction (IBR) as a breast cancer treatment option remains controversial. We assessed the impact of NAC on surgical and oncological outcomes of patients undergoing IBR. Methods This was a retrospective multicenter study of 4726 breast cancer cases undergoing IBR. The rate of postoperative complications and survival data were compared between IBR patients who received NAC and those who did not receive NAC. Propensity score matching analysis was performed to mitigate selection bias for survival. Results Of the total 4726 cases, 473 (10.0%) received NAC. Out of the cases with NAC, 96 (20.3%) experienced postoperative complications, while 744 cases (17.5%) without NAC had postoperative complications. NAC did not significant increase the risk of complications after IBR (Odds ratio, 0.96; 95%CI 0.74–1.25). At the median follow-up time of 76.5 months, 36 patients in the NAC group and 147 patients in the control group developed local recurrences. The 5-year local recurrence-free survival rate was 93.1% in the NAC group and 97.1% in the control group. ( P