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. 2023 Dec;30(13):8362-8370.
doi: 10.1245/s10434-023-14177-w. Epub 2023 Aug 21.

Effect of Delayed Oncoplastic Reduction Mammoplasty on Radiation Treatment Delay Following Breast-Conserving Surgery for Breast Cancer

Carolina E Fasola  1 , Hadley J Sharp  1 , Nicholas W Clavin  2 , Wei Sha  3 , Courtney R Schepel  4 , Sally J Trufan  3 , Elaina Graham  5 , Anna Hecksher  4 , Richard L White Jr  5 , Lejla Hadzikadic-Gusic  6
Affiliations

Effect of Delayed Oncoplastic Reduction Mammoplasty on Radiation Treatment Delay Following Breast-Conserving Surgery for Breast Cancer

Carolina E Fasola et al. Ann Surg Oncol. 2023 Dec.

Abstract

Background: The purpose of this study was to evaluate the delay in initiating adjuvant radiation therapy (RT) after breast-conserving surgery (BCS) in patients with early-stage breast cancer who underwent oncoplastic reduction mammoplasty (ORM) following BCS compared with a matched cohort of patients who did not undergo ORM between BCS and RT.

Methods: Medical records of 112 women (56 ORMs and 56 matched non-ORMs) with carcinoma in situ or early-stage breast cancer treated with BCS were reviewed. ORM was performed in a delayed manner following BCS, allowing confirmation of negative surgical margins. Time to RT was defined as time from last oncologic surgery to start of RT.

Results: The median follow-up time was 6.8 years for the ORM cohort and 6.7 years for the control non-ORM cohort. Patients who underwent ORM following BCS experienced a significant delay in initiating RT (>8 weeks) than matched patients not undergoing ORM (66% vs. 34%; p < 0.001). Wound complications occurred in 44.6% (n = 25) of patients in the ORM cohort, which were mostly minor, including delayed wound healing and/or infection (39%). There was no significant difference in local recurrence between patients in the non-ORM and ORM cohorts (p = 0.32).

Conclusions: This study demonstrates that ORM following BCS has the potential to delay RT >8 weeks, largely as a result of increased risk of wound complications; however, this delay did not impact local control. ORM can be safely considered for appropriately selected patients with breast cancer.

Keywords: Breast cancer; Breast-conserving therapy; Oncoplastic reconstruction; Radiation delay.

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