The effects of neoadjuvant and adjuvant chemotherapy on the surgical outcomes of breast reconstruction.
Breast reconstruction following mastectomy has become, in many centers the standard of care. An increasingly encountered trend is the use of neoadjuvant chemotherapy to downstage high stage tumors and to decrease tumor burden prior to definitive oncologic surgery. These agents clearly provide a survival benefit, but also have the potential to adversely affect the surgical course of immediate and delayed breast reconstruction. The use of new biologic and hormonal agents may also have effects on surgery and reconstruction. Furthermore, chemotherapeutic agents as a whole may impair cellular functions necessary for normal recovery from surgery. In this paper we present a concise review for the reconstructive surgeon on adverse effects of chemotherapeutic, hormonal and biologic agents used for treatment of breast cancer, important perioperative issues, and also discuss their potential effect on breast reconstruction.
Department of Plastic Surgery, Case School of Medicine, 11100 Euclid Avenue, Cleveland, OH 44106, USA.
Eugene
E
Oh
Harvey
H
Chim
Hooman T
HT
Soltanian
D000328:Adult; D000367:Age Factors; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D001688:Biological Products / Q000009:adverse effects / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects*; D005260:Female; D006084:Graft Rejection / Q000517:prevention & control*; D020249:Hormone Replacement Therapy / Q000009:adverse effects / Q000379:methods; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects / Q000379:methods*; D008408:Mastectomy / Q000379:methods*; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000009:adverse effects*; D011182:Postoperative Care / Q000379:methods; D011379:Prognosis; D018570:Risk Assessment; D014945:Wound Healing / Q000187:drug effects
D001688:Biological Products