title: Prospective randomized study of surgical morbidity following primary systemic therapy for breast cancer.
abstract: The influence of primary systemic therapy in treating operable breast cancer on postmastectomy morbidity rates was investigated. The contribution of other risk factors was assessed by multiple logistic regression. Seventy-nine eligible patients were randomly allocated, 39 to undergo immediate modified radical mastectomy, and 40 to receive initial cytotoxic or endocrine treatment followed by mastectomy. Postoperative wound seroma, infection and necrosis were recorded prospectively. Fourteen minor and six major complications occurred in 17 patients treated conventionally, while 14 patients developed 11 minor and six major complications after systemic therapy (P > 0.4). Median hospital stay was 8 days for both groups. Age, smoking, immediate breast reconstruction and the type of primary systemic treatment given were not independent predictors of complication risk. Obesity emerged as a significant risk factor for postmastectomy complications (P = 0.015). Primary systemic therapy does not increase the rate of morbidity after mastectomy.
authors.affiliation: Edinburgh Breast Unit, Western General Hospital, UK.
authors.forename: P
authors.initials: P
authors.lastname: Forouhi
authors.forename: J M
authors.initials: JM
authors.lastname: Dixon
authors.forename: R C
authors.initials: RC
authors.lastname: Leonard
authors.forename: U
authors.initials: U
authors.lastname: Chetty
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy / Q000453:epidemiology / Q000601:surgery*; D003131:Combined Modality Therapy / Q000009:adverse effects; D005260:Female; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D015409:Mastectomy, Radical / Q000009:adverse effects*; D008875:Middle Aged; D009017:Morbidity; D011446:Prospective Studies; D012307:Risk Factors