Preoperative chemotherapy for T2 breast cancer is associated with improved surgical outcome

Does neoadjuvant chemotherapy affect morbidity, mortality, reoperations, or readmissions in patients undergoing lumpectomy or mastectomy for breast cancer?

“…We identified no association between NAC and reoperations or readmissions during any period of our study for either lumpectomy or mastectomy, corroborating prior reports that utilized slightly different analytic methodologies and procedure types, including reconstruction (7,10,12). Although the absolute differences were often small, we found multiple significant differences between patient characteristics (confounding variables) by receipt of NAC in the NSQIP registry ( Table 2).…”

“…Gland Surg 2017;6(1):14-26 gs.amegroups.com complication type, agents used, and whether radiation was delivered preoperatively (6)(7)(8)(9)13,(16)(17)(18)(19)(20)(21)(22)(23)(24)(25). Findings also vary between studies of the same organ ( Table 1) (6)(7)(8)(9)(10)(11)(12)37). In some reports of organ sites other than breast, NAC was associated with increased transfusions, readmissions, SSI, stroke, and mortality (13,15,21,22,24,25).…”

“…Utilizing the statistical power of national databases, only a few studies have reported postoperative outcomes after receipt of NAC in patients with breast cancer (6)(7)(8)(9). Due to the smaller number of patient encounters, single-institution reports of the effect of NAC on postoperative complications after breast surgery are more limited in their ability to distinguish differences in complications attributed to NAC (10)(11)(12). The association of NAC with morbidity and mortality (M&M) for organ sites other than breast has been reported many times (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26), but these reports may not be relevant for breast patients.…”

Fewer Reoperations After Lumpectomy for Breast Cancer with Neoadjuvant Rather than Adjuvant Chemotherapy: A Report from the National Cancer Database

“…Few studies have reported the effect of NAC on breast reoperations 21–24. Single-institution reports from Turkey and the University of Michigan associated NAC with a modest reduction in lumpectomy ROR 22,23. In contrast, Al-Hilli et al21 found no change in ROR for patients undergoing mastectomy captured from the NSQIP database, and Volders et al24 reported higher ROR after NAC for patients undergoing breast-conserving therapy in the Dutch Pathology Registry.…”

Association of surgical margins with local recurrence in patients undergoing breast-conserving surgery after neoadjuvant chemotherapy

“…Christy et al [25] demonstrated that preoperative chemotherapy resulted in a significantly higher incidence of negative margins (90% vs. 55%; P < 0.01) and a lower re-excision rate (6% vs. 37%; P < 0.01) compared with primary surgery. Karanlik et al [26] reported that NACT was more likely to have negative margins (95% vs. 84%; P = 0.02) and less likely receive re-excision (4% vs. 8%; P = 0.02) as well.…”