Influence of Adjuvant Radiotherapy Timing on Survival Outcomes in High-Risk Patients Receiving Neoadjuvant Treatments

Cao, Lu; Xu, Cheng; Wang, Meng-Di; Qi, Wei-Xiang; Cai, Gang; Cai, Rong; Wang, Shubei; Ou, Dan; Li, Min; Shen, Kunwei; Chen, Jiayi

doi:10.3389/fonc.2022.905223

Cited by 1 publication

(2 citation statements)

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“…25 It is well described that ipsilateral breast recurrence, the occurrence of distant metastases, and breast cancer-specific survival rates are all adversely affected by postoperative delays in initiating any postsurgical breast cancer treatment, including radiation therapy (RT), antiestrogen therapy, and chemotherapy. [26][27][28][29][30][31][32][33][34][35][36][37] Recently, these long-held tenets have been questioned within certain subsets of patients. 38,39 Delays in adjuvant treatments after mastectomy appear less adverse than similar delays after OBS.…”

Section: Discussionmentioning

confidence: 99%

“…27,28,[32][33][34][35] Moreover, the effect delay has on these outcomes also seems to be stratified by tumor-specific biology; least pronounced with noninvasive ductal carcinoma in situ and more pronounced with aggressive triple-negative invasive breast cancers. [26][27][28][29][30]37 In 1323 patients with ductal carcinoma in situ treated with OBS, initiation of adjuvant RT within 8-12 weeks of surgery resulted in 5.8% of 5-year and 13% of 10-year ipsilateral breast recurrence, respectively. However, when adjuvant RT was started after 12 weeks, ipsilateral breast recurrence increased to 8.8% and 23% at 5 and 10 years, respectively.…”

Section: Discussionmentioning

confidence: 99%

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Oncoplastic Breast Reduction: A Systematic Review of Postoperative Complications

Benedict,

Brown,

Berry

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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Background: Breast-conserving therapy with oncoplastic reduction is a useful strategy for partial mastectomy defect reconstruction. The most recently published systematic review of oncoplastic breast reduction outcomes from 2015 showed wound dehiscence in 4.3%, hematoma in 0.9%, infection in 2.8%, and nipple necrosis in 0.9% of patients. We performed a systematic review of oncoplastic breast reduction literature, comparing outcomes and complication rates reported over the past 8 years. Methods: Studies describing the use of oncoplastic breast reduction and discussion of postoperative complications were included. The primary outcome assessed was the postoperative complication rate; secondary outcomes analyzed were rates of margin expansion, completion mastectomy, and delays in adjuvant therapy due to complications. Results: Nine articles met inclusion criteria, resulting in 1715 oncoplastic breast reduction patients. The mean rate of hematoma was 3%, nipple necrosis was 2%, dehiscence was 4%, infection was 3%, and seroma was 2%. The need for re-excision of margins occurred in 8% of patients, and completion mastectomy in 2%. Finally, delay in adjuvant treatment due to a postoperative complication occurred in 4% of patients. Conclusions: Oncoplastic breast reduction is an excellent option for many patients undergoing breast-conserving therapy; however, postoperative complications can delay adjuvant radiation therapy. Results of this systematic literature review over the past 8 years showed a slight increase in complication rate compared to the most recent systematic review from 2015. With increased popularity and surgeon familiarity, oncoplastic breast reduction remains a viable option for reconstruction of partial mastectomy defects despite a slight increase in complication rate.

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