title: Neoadjuvant therapy and breast cancer surgery: a closer look at postoperative complications.
abstract: BACKGROUND
  Neoadjuvant therapy is important in the treatment of advanced breast cancer.
  
  
  METHODS
  Postoperative complications in neoadjuvant patients were analyzed.
  
  
  RESULTS
  One hundred forty patients underwent 148 breast cancer surgeries after neoadjuvant therapy: 28% breast-conserving therapy procedures, 36% mastectomies, 28% mastectomies with immediate reconstruction, and 8% mastectomies with delayed reconstruction. Forty-seven patients (34%) suffered 59 complications: 18% of those undergoing breast-conserving therapy, 30% of those undergoing mastectomy, 44% of those undergoing mastectomy with immediate reconstruction, and 67% of those undergoing mastectomy with delayed reconstruction. Major complications occurred in 18% of patients. Skin loss occurred in 6% of patients. One patient had partial nipple necrosis. Three patients suffered implant loss. One patient had deep inferior epigastric artery perforator flap loss. Eleven hematomas and 5 infectious complications required reoperation.
  
  
  CONCLUSIONS
  Surgery after neoadjuvant therapy is safe, but careful counseling is warranted given that 18% of patients experienced major complications. Complications rates are higher with reconstruction, but feared complications of skin, nipple, implant, or flap loss were infrequent.
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Mayo Clinic Arizona, 5777 East Mayo Boulevard, Phoenix, AZ 85054, USA.
authors.forename: Erin M
authors.initials: EM
authors.lastname: Garvey
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Gray
authors.forename: Nabil
authors.initials: N
authors.lastname: Wasif
authors.forename: William J
authors.initials: WJ
authors.lastname: Casey
authors.forename: Alanna M
authors.initials: AM
authors.lastname: Rebecca
authors.forename: Peter
authors.initials: P
authors.lastname: Kreymerman
authors.forename: Deborah
authors.initials: D
authors.lastname: Bash
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Pockaj
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001130:Arizona / Q000453:epidemiology; D001943:Breast Neoplasms / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008408:Mastectomy / Q000009:adverse effects*; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D011182:Postoperative Care / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology*; D011379:Prognosis; D011446:Prospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D055815:Young Adult
keywords: Breast cancer surgery; Neoadjuvant; Postoperative complications