Background
•<10% of patients undergo breast reconstruction following breast-conserving surgery.1
•Oncoplastic reduction mammaplasty = partial mastectomy + breast reduction → optimizes aesthetic and oncologic outcomes.2
•Complication rate reported up to 34%... delays adjuvant treatment?3
Aim
•Investigate the incidence and impact of complications after oncoplastic reduction on timing to adjuvant radiation therapy.
•Identify if delays were related to specific surgical techniques.
Methods
•Retrospective review of oncoplastic reduction mammoplasty patients at UCSF between 2020-2023
•Exclusion criteria: patients who received adjuvant chemotherapy or required further surgeries prior to start of adjuvant radiation
•Primary outcome: time to adjuvant radiation therapy (delay = therapy initiation >12 weeks (84 days) after reduction)
•Complications = infection, delayed wound healing, seroma, and hematoma
Results
Patient Demographics
•Total N = 104
•Mean Age = 53.9 (± 12.1)
•Mean BMI = 28.8 (± 6.4)
•Average time to radiation = 85 days (± 49)
•Average time to radiation if no delay = 72 days (± 46)
•Average time to radiation if delayed = 110 days (± 44)
Conclusions & Next Steps
•Our study confirms that wound healing complications significantly impact timing of adjuvant radiation therapy (p<.0001)
•Patients who have wound healing complications are at 6.11 times more risk of a delay to adjuvant radiation than those who do not have wound healing complications
•Risk factors for wound healing complications include BMI (RR 1.15)
•Future directions → expand N and investigate impact of preoperative breast volume, tumor volume, and specific post-operative complications on outcomes
Acknowledgements and Citations
Project funded in part by the UCSF Prime Grant.
1. Albornoz CR, Matros E, Lee CN, et al. Bilaterality and Reconstruction Rates in Breast Cancer Surgery: A National Perspective. J Clin Oncol. 2014;32(9):919–926. doi: 10.1200/JCO.2013.52.8645. 2. Losken A, Elwood ET, Styblo TM, et al. The role of reduction mammaplasty in reconstructing partial mastectomy defects. Plast Reconstr Surg. 2002;109:968-975. 3. Mattingly A, et al. Complication Rates Associated with Oncoplastic Reduction Mammoplasty: A Retrospective Review. J Surg Oncol. 2021;124(3):456-462. doi:10.1002/jso.26578.
