title: Oncoplastic breast conservation does not lead to a delay in the commencement of adjuvant chemotherapy in breast cancer patients.
abstract: BACKGROUND
  There is hardly any evidence that oncoplastic breast conservation surgery (OBCS) does not lead to a delay in the commencement of adjuvant chemotherapy. Although this is an integral part of overall oncological safety, no controlled studies have been published so far. Therefore, our aim was to determine whether OBCS led to a delay when compared to simple wide local excision (WLE), mastectomy (Ms) or mastectomy with immediate reconstruction (MsIR).
  
  
  METHODS
  Breast cancer patients who required adjuvant chemotherapy after OBCS, WLE, Ms and MsIR were identified from prospectively maintained institutional databases. Time between multidisciplinary team decision to offer chemotherapy and delivery of first cycle of chemotherapy was measured and compared among the four groups of patients.
  
  
  RESULTS
  time to chemotherapy of breast cancer patients (n = 169) treated with OBCS (n = 31) were 29 [16-58] days, while it was 29.5 [15-105] days after WLE (n = 66), 29 [15-57] days after Ms (n = 56) and 31 [15-58] days after MsIR (n = 16). A combined analysis involving all four groups demonstrated no statistically significant difference (p = 0.524). Similarly, inter-group analysis revealed no significant differences in between patients treated with OBCS compared to any of the three control groups (OBCS to WLE: p = 0.433; OBCS to Ms: p = 0.800; OBCS to MsIR: p = 0.405).
  
  
  CONCLUSIONS
  OBCS seems as safe as WLE, Ms or MsIR in terms of delivery of adjuvant chemotherapy, and, therefore, should not adversely affect breast cancer outcome in this respect.
authors.forename: J
authors.initials: J
authors.lastname: Khan
authors.affiliation: Victoria Infirmary Glasgow, Langside Road, Glasgow G42 9TY, United Kingdom.
authors.forename: J
authors.initials: J
authors.lastname: Kahn
authors.forename: S
authors.initials: S
authors.lastname: Barrett
authors.forename: C
authors.initials: C
authors.lastname: Forte
authors.forename: S
authors.initials: S
authors.lastname: Stallard
authors.forename: E
authors.initials: E
authors.lastname: Weiler-Mithoff
authors.forename: J C
authors.initials: JC
authors.lastname: Doughty
authors.forename: L
authors.initials: L
authors.lastname: Romics
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects / Q000379:methods*; D008408:Mastectomy / Q000379:methods; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000401:mortality; D061214:Patient Safety; D011182:Postoperative Care / Q000379:methods; D011446:Prospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D013997:Time Factors; D006113:United Kingdom; D055815:Young Adult
keywords: Adjuvant chemotherapy delivery; Ms; MsIR; OBCS; Oncoplastic breast conservation; WLE; mastectomy; mastectomy and immediate reconstruction; oncoplastic breast conservation surgery; wide local excision