title: The impact of immediate breast reconstruction after mastectomy on time to first adjuvant treatment in women with breast cancer in a community setting.
abstract: BACKGROUND
  The impact of immediate breast reconstruction on the time to first adjuvant therapy is controversial.
  
  
  METHODS
  Retrospective study design comparing time to first treatment in women undergoing mastectomy with and without immediate reconstruction in a community cancer center.
  
  
  RESULTS
  Seventy-six cases fit inclusion criteria of which 44 (58%) underwent mastectomy with immediate reconstruction. Women undergoing immediate reconstruction were younger, had more bilateral mastectomies and had fewer prior breast procedures. The median time to first adjuvant therapy was longer in the immediate reconstruction group [80.5days (36-343) versus 53.5 days (18-96), p = 0.003]. Fifteen of 44 patients had the start of adjuvant treatment over 90 days after resection, 14 of whom (93%) had immediate reconstruction versus 1 (7%) who did not (p = 0.01).
  
  
  CONCLUSIONS
  In this study immediate breast reconstruction was associated with a longer time to first adjuvant treatment, with adjuvant therapies being more likely delayed over 90 days.
authors.affiliation: Goshen Center for Cancer Care, Goshen, IN 46506, USA. Electronic address: lhenry@goshenhealth.com.
authors.forename: L R
authors.initials: LR
authors.lastname: Henry
authors.affiliation: Goshen Center for Cancer Care, Goshen, IN 46506, USA.
authors.forename: L L
authors.initials: LL
authors.lastname: Morris
authors.affiliation: Goshen Center for Cancer Care, Goshen, IN 46506, USA.
authors.forename: R
authors.initials: R
authors.lastname: Downs
authors.affiliation: Goshen Center for Cancer Care, Goshen, IN 46506, USA.
authors.forename: R E
authors.initials: RE
authors.lastname: Schwarz
mesh_terms: D000367:Age Factors; D001943:Breast Neoplasms / Q000628:therapy*; D002173:Cancer Care Facilities; D017024:Chemotherapy, Adjuvant; D003151:Community Health Centers; D005260:Female; D006801:Humans; D016462:Mammaplasty; D008408:Mastectomy; D008875:Middle Aged; D011183:Postoperative Complications; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D061665:Time-to-Treatment
keywords: Adjuvant therapy; Breast cancer; Immediate reconstruction