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Immediate Breast Reconstruction After Mastectomy Increases Wound Complications
However, Initiation of Adjuvant Chemotherapy Is Not Delayed
Melinda M. Mortenson, MD;
Philip D. Schneider, MD, PhD;
Vijay P. Khatri, MD;
Thomas R. Stevenson, MD;
Thomas P. Whetzel, MD;
Eiler J. Sommerhaug, MD;
James E. Goodnight, Jr, MD, PhD;
Richard J. Bold, MD
Arch Surg. 2004;139:988-991.
Background Immediate breast reconstruction is being increasingly used after mastectomy, although it may increase the incidence of wound complications. The indications for chemotherapy in breast cancer are expanding and wound complications following mastectomy may delay the initiation of adjuvant chemotherapy.
Hypothesis Immediate breast reconstruction after mastectomy for breast cancer does not lead to an increased incidence of wound complications nor delay the initiation of systemic chemotherapy.
Design and Setting Retrospective medical record review at a tertiary care center.
Patients One hundred twenty-eight women treated with a mastectomy for breast cancer over an 8-year period (January 1, 1995, through December 31, 2002).
Main Outcome Measures Surgical site complications (infectious and noninfectious) and time to initiation of postoperative chemotherapy.
Results One hundred forty-eight mastectomy procedures in 128 women with breast cancer were evaluated. We analyzed 4 subgroups according to whether or not immediate breast reconstruction was part of the surgical procedure (76 or 72 procedures, respectively) and whether or not postoperative adjuvant chemotherapy was administered (81 or 47 patients, respectively). There was an increased incidence of wound complications in patients who underwent immediate breast reconstruction compared with those who did not (6/72 [8.3%] vs 17/76 [22.3%]; P = .02). However, these complications did not delay initiation of postoperative chemotherapy.
Conclusions Although we observed an increased incidence of wound complications when immediate breast reconstruction was combined with mastectomy, there was no delay in the initiation of adjuvant therapy. Immediate breast reconstruction should remain an important treatment option after mastectomy even when postoperative chemotherapy is anticipated.
From the Divisions of Surgical Oncology (Drs Mortenson, Schneider, Khatri, Goodnight, and Bold) and Plastic Surgery (Drs Stevenson, Whetzel, and Sommerhaug), Department of Surgery, University of California, Davis Medical Center, Sacramento.
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