title: Immediate reconstruction after mastectomy for breast cancer does not prolong the time to starting adjuvant chemotherapy.
abstract: BACKGROUND
  Immediate breast reconstruction is often performed after mastectomy for breast cancer. There has been concern that this will result in a delay in initiating chemotherapy and, as a consequence, may adversely impact survival. In this study we sought to determine whether immediate breast reconstruction affects the interval between surgery and adjuvant chemotherapy.
  
  
  METHODS
  A single institution retrospective analysis was made using the institutional tumor registry and chart reviews.
  
  
  RESULTS
  Forty-nine patients were identified who had undergone mastectomy with immediate reconstruction followed by adjuvant chemotherapy. They were compared with 308 patients undergoing mastectomy without reconstruction. Patients who underwent reconstruction were overall younger (46 versus 55, P <0.001), and had more advanced disease. The time to chemotherapy was significantly longer in the group receiving no reconstruction: 53 versus 41 days (P = 0.039). The type of reconstruction did not affect the time to chemotherapy.
  
  
  CONCLUSIONS
  Immediate reconstruction after mastectomy does not increase the time to chemotherapy compared with mastectomy alone.
authors.affiliation: Center for Breast Health and the Department of Surgery, Washington Cancer Institute, Washington, DC, USA.
authors.forename: Tanir M
authors.initials: TM
authors.lastname: Allweis
authors.forename: Marc E
authors.initials: ME
authors.lastname: Boisvert
authors.forename: Susan E
authors.initials: SE
authors.lastname: Otero
authors.forename: David J
authors.initials: DJ
authors.lastname: Perry
authors.forename: Norman H
authors.initials: NH
authors.lastname: Dubin
authors.forename: Dennis A
authors.initials: DA
authors.lastname: Priebat
mesh_terms: D000009:Abdominal Muscles / Q000637:transplantation; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D019928:Breast Implantation / Q000379:methods*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D016022:Case-Control Studies; D017024:Chemotherapy, Adjuvant; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015409:Mastectomy, Radical / Q000379:methods; D008875:Middle Aged; D009367:Neoplasm Staging; D011336:Probability; D019651:Plastic Surgery Procedures / Q000379:methods*; D012016:Reference Values; D012042:Registries; D012189:Retrospective Studies; D013524:Surgical Flaps; D013997:Time Factors; D016896:Treatment Outcome