Surgical timing following neoadjuvant chemotherapy for breast cancer affects postoperative complication rates

Am J Surg. 2020 May;219(5):741-745. doi: 10.1016/j.amjsurg.2020.02.061. Epub 2020 Mar 10.

Abstract

Background: Neoadjuvant chemotherapy (NAC) is increasingly used in the treatment of breast cancer. The time interval from last dose of cytotoxic chemotherapy to surgery (TTS) can vary widely. We aimed to evaluate the effect of TTS on postoperative complications.

Methods: A retrospective review for women treated with NAC at our institution between January 2011 through December 2016 was performed. Charts were reviewed for postoperative wound complications, and multivariate analysis was performed.

Results: 455 patients were identified. Median TTS was 30 days (range 11-228). On multivariate analysis, TTS of less than 28 days was associated with 70% higher odds of any wound complication (p < 0.05). Increasing age had the strongest association with the presence of any wound complication (p < 0.0001). The majority of complications were treated in the outpatient setting (n = 80, 83%).

Conclusion: Following NAC for breast cancer, TTS less than 28 days is a risk factor for postoperative wound complications; however, the majority of complications are minor and treated in the outpatient setting. Additional data are needed to determine optimal TTS for oncologic outcomes.

Keywords: Breast cancer; Complications; Neoadjuvant chemotherapy; Time to surgery.

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / surgery*
  • Chemotherapy, Adjuvant*
  • Female
  • Humans
  • Middle Aged
  • Neoadjuvant Therapy
  • Postoperative Complications / epidemiology*
  • Registries
  • Retrospective Studies
  • Risk Factors
  • Time-to-Treatment*