Neoadjuvant chemotherapy worsens survival after breast reconstruction

Neoadjuvant chemotherapy (NACT) may lead to worse overall survival in women who had undergone mastectomy and immediate breast reconstruction (MIBR), a recent study has found.

Researchers conducted a 6-year retrospective analysis of 300 breast cancer patients who underwent MIBR for breast cancer. Most (n=277, 92 percent) also received NACT, while the remaining 23 (7.7 percent) did not. The primary outcome was a delay in adjuvant radiotherapy; secondary outcomes included locoregional recurrence and the incidence of postoperative complications.

Overall, complications occurred at a comparable rate between the NACT and non-NACT groups (21.7 percent vs 37.5 percent; p=0.148). Major (29.6 percent vs 21.7 percent; p=0.823) and minor (26.7 percent vs 8.7 percent; p=0.097) complications were likewise statistically comparable between NACT and non-NACT groups.

Similarly, adjuvant therapy did not differ between groups and was administered to 56.5 percent of NACT patients and to 49.1 percent of non-NACT patients (p=0.640). Time from surgery to adjuvant therapy did not differ between groups (2.12 vs 2.26 months; p=0.629), nor was the reported delay to adjuvant therapy (21.7 percent vs 9.75 percent; p=0.305).

Locoregional recurrence also did not differ between groups (4.35 percent vs 3.25 percent; p=1.00). However, patients who received NACT showed significantly lower overall survival rate than their non-NACT counterparts (82.6 percent vs 98.2 percent; p<0.001).

“Patients with and without NACT undergoing MIBR had similar rates of complications, locoregional recurrence, and delays to adjuvant therapy. MIBR should therefore be discussed as a potential option for select patients undergoing NACT,” the researchers said.