Immediate breast reconstruction after mastectomy does not delay chemotherapy

EMBARGOED FOR RELEASE UNTIL 3 P.M. (CT), MONDAY, SEPTEMBER 20, 2004 CHICAGO – Although there is an increased risk of wound complications in patients who underwent breast reconstruction directly after mastectomy, the procedure did not delay the initiation of postsurgical chemotherapy, according to an article in the September issue of The Archives of Surgery, one of the JAMA/Archives journals.

According to the article, "breast cancer is the most common cancer diagnosed in women in the United States today with an expected incidence of more than 200,000 women in 2003." Breast reconstruction has been shown to reduce the negative effects on self-image and psychosocial well being in women after mastectomy (removal of the breast), the article states. However, it is unknown whether wound complications following mastectomy and breast reconstruction have any effect on the initiation of chemotherapy after surgery.

Melinda M. Mortenson, M.D., of the University of California, Davis Medical Center, Sacramento, and colleagues reviewed the medical records of 128 women to determine whether the risk of wound complications was higher in women when breast reconstruction was combined with mastectomy and whether wound complications delayed the initiation of postoperative chemotherapy.

There were 148 mastectomy procedures among the 128 women whose medical records were reviewed. Sixty-two patients underwent immediate breast reconstruction after their mastectomies, and 81 patients received postoperative chemotherapy.

The overall rate of wound complications was 15.5 percent. The researchers found that 22.3 percent of patients who underwent immediate breast reconstruction after their mastectomies developed wound complications vs. 8.3 percent of patients who did not have immediate breast reconstruction. However, these complications did not interfere with chemotherapy after surgery.

"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," write the authors. "Immediate breast reconstruction should remain an important treatment option after mastectomy even when postoperative chemotherapy is anticipated."

(Arch Surg. 2004;139:988-991. Available post-embargo at archsurg.com)

For more information, contact JAMA/Archives Media Relations at 312-464-JAMA (5262) or e-mail mediarelations@jama-archives.org .

To contact corresponding author Richard Bold, M.D., call Claudia Morain at 916-734-9023.

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