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The Impact of Oncoplastic Reduction Mammoplasty on Timing of Adjuvant Radiation
Reta Behnam-Hanona, BA, Michael Choi, MS, Daniel Soroudi, BS, Adeline RA, -, Jacquelyn A. Knox, MD, Merisa Piper, MD.
University of California, San Francisco, San Francisco, CA, USA.
PURPOSE While oncoplastic reduction mammoplasty has benefits over lumpectomy for the treatment of breast cancer, complications are reported up to 50%. This raises the concern that complications may delay adjuvant treatment. We aimed to investigate the incidence and impact of complications after oncoplastic reduction on timing to adjuvant radiation therapy.
METHODS We performed a retrospective review of patients who underwent oncoplastic reduction mammoplasty at our urban tertiary care center between 2020-2023. Patients who received adjuvant chemotherapy, or had further surgeries prior to adjuvant radiation, were excluded. The primary outcome was timing to adjuvant radiation therapy, with a delay defined as beginning therapy 12 weeks or more after reduction. Wound healing complications were defined as infection, wound healing delay, seroma, and hematoma.
RESULTS We identified 104 patients who met inclusion criteria. Of those, 91 patients (88%) had Wise pattern incisions. 18 (17%) had superomedial pedicles and 77 (74%) had inferior pedicles. Overall wound healing complication rate was 21%. 35 patients (34%) had delayed start of their adjuvant radiation. Neither pedicle (p=0.26) nor incision type (p=0.18) were significantly associated with delayed radiation therapy. However, 49% of delays were due to wound healing problems. Patients with wound healing complications had a significantly higher rate of delayed treatment than patients without wound healing complications, at 77% compared to 22% (p<0.0001).
CONCLUSIONS Our study confirms that wound healing complications, although unrelated to technique, are a significant concern after oncoplastic reduction mammoplasty and that patients with wound healing complications do experience higher rates of delayed treatment.
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