Time to first adjuvant treatment after oncoplastic breast reduction

Background: Oncoplastic breast reduction (OBR) allows breast conservation surgery (BCS) to be combined with breast reduction for select patients. The objective of this study was to measure time to first adjuvant treatment (AT) in patients who undergo OBR and to evaluate whether initiation dates conf...

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Bibliographic Details
Published in:Canadian Journal of Surgery 2021-12, Vol.64, p.S139-S139
Main Authors: Mysuria, S, Bazzarelli, A, Pao, J, Chen, L, Zhang, M, McKevitt, E, Warburton, R, Kuusk, U, Van Laeken, N, Bovill, E, Isaac, K, Dingee, C
Format: Article
Language:English
Subjects:
Breast cancer
Chemotherapy
Radiation
Surgery
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Summary:Background: Oncoplastic breast reduction (OBR) allows breast conservation surgery (BCS) to be combined with breast reduction for select patients. The objective of this study was to measure time to first adjuvant treatment (AT) in patients who undergo OBR and to evaluate whether initiation dates conformed to conventional post-BCS treatment windows for radiation (RT), chemotherapy and endocrine management. Methods: Institutional and university ethics boards approved this retrospective review, which included all patients receiving OBR from April 2009 to April 2020. Consecutive patients were identified from operative slates. Data were extracted from a prospectively maintained database and surgeons electronic medical records. The relative start date (RST) of AT was calculated as the time elapsed between the OBR date and the earliest start date or the first day after resolution of delays due to medical reasons or patient preference. Results: This study included 5504 new breast cancer cases, and 81 had OBR. Patients who underwent OBR had unilateral (n = 79) or bilateral (n = 1) breast cancer, malignant phyllodes tumour (n = 1), had bilateral (n = 73) or unilateral (n = 8) OBR, and had OBR as a first surgery (n = 69) or during margin re-excision after BCS (n = 12). Additional surgery after OBR was required by 7 patients for margin revision (n = 6) or sentinel node biopsy (n = 1), while 7 had completion mastectomy. No patients required reoperation for debridement, or hematoma evacuation. In total, 72 (88.9%) patients received AT: 36 started with radiation, 19 with chemotherapy and 17 with endocrine management. RST averaged 9.4 weeks for radiation, 7.0 weeks for chemotherapy, 8.0 weeks for endocrine and 8.4 weeks for any AT. Among patients receiving AT, 70 (97.2%) initiated AT by week 16, and 100% of patients who received chemotherapy initiated AT by week 12. Conclusion: The average time to first adjuvant treatment conformed to local recommendations for chemotherapy (aim for 6-8 wk after ablative surgery), radiation (optimally within 10 wk of surgery but no detriment to delay up to 20 wk) and endocrine therapy (no absolute upper limit to the window for initiation).
ISSN:0008-428X
1488-2310