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Immediate breast reconstruction after mastectomy does not delay adjuvant therapy

April 24, 2019 16:37

Immediate breast reconstruction after mastectomy for cancer does not delay the start of adjuvant therapy, according to a study iBRA-2.

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"Immediate reconstruction does not delay further treatment, but major complications after reconstruction on the basis of the implant is much higher. If patients develop complications, which may lead to delays in treatment, "- says Dr. Shelley Potter School of Medicine in Bristol.  

Delay adjuvant chemotherapy for more than 90 days has a negative impact on survival, but data on the effect of immediate breast reconstruction for the duration of adjuvant treatment are inconsistent.

Dr. Potter and his colleagues investigated whether the reconstruction at the time of the effect of adjuvant therapy compared with mastectomy alone. The study involved 2,540 women, 1008 (39.7%) of whom suffered reconstruction.

Overall, 929 patients (36.6%) experienced at least one post-operative complication, and 221 patients (8.7%) experienced serious complications requiring readmission or further operation.

Bilateral surgery and reconstruction using flaps were independent risk factors for postoperative complications. The researchers looked at the timing of the first adjuvant therapy, chemotherapy, and radiation therapy, depending on whether a woman has a minor or major complications.

Women who experience complications significantly more often faced with considerable delays of chemotherapy and radiation therapy compared with women who had uncomplicated procedure.

"The high rate of complications in all groups of patients is of concern and underlines the need to improve outcomes for patients, - says Dr. Potter. - Careful selection of patients and deliberate joint decision-making with accurate information on risks is vital for patients who are considering immediate breast reconstruction, when probably require adjuvant treatment. "

Dr. Sharon S. Lum, medical director of the Medical Center's breast at the Medical Faculty of the University of Loma Linda in California, writes: "In general, research shows that there is no clinically significant delay in time from the final operation before the start of subsequent therapy, regardless of exposed a woman reconstruction. Clinicians do a good job on the selection of patients for reconstruction, but it is necessary to study the clinical paths and improved recovery protocols after surgery to reduce complications. "



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