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

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

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.

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Acknowledgment

The authors thank Michelle L. Wallander, PhD, who provided writing support.

Funding

This research did not receive any specific grants from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Radiation Oncology, Levine Cancer Institute, Atrium Health, Charlotte, NC, USA

    Carolina E. Fasola MD, MPH & Hadley J. Sharp MD

  2. Division of Plastic and Reconstructive Surgery, Atrium Health, Charlotte, NC, USA

    Nicholas W. Clavin MD

  3. Department of Biostatistics, Levine Cancer Institute, Atrium Health, Charlotte, NC, USA

    Wei Sha PhD & Sally J. Trufan MS

  4. Clinical Trials Office, Levine Cancer Institute, Atrium Health, Charlotte, NC, USA

    Courtney R. Schepel BS & Anna Hecksher BS

  5. Division of Surgical Oncology, Levine Cancer Institute, Atrium Health, Charlotte, NC, USA

    Elaina Graham DO, Richard L. White Jr. MD, FACS, FSSO & Lejla Hadzikadic-Gusic MD, MSc, FACS, FSSO

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  1. Carolina E. Fasola MD, MPH
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Correspondence to Lejla Hadzikadic-Gusic MD, MSc, FACS, FSSO.

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Disclosures

Carolina E. Fasola, Hadley J. Sharp, Nicholas W. Clavin, Wei Sha, Courtney R. Schepel, Sally J. Trufan, Elaina Graham, Anna Hecksher, Richard L. White Jr, and Lejla Hadzikadic-Gusic have declared no conflicts of interest.

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Fasola, C.E., Sharp, H.J., Clavin, N.W. et al. Effect of Delayed Oncoplastic Reduction Mammoplasty on Radiation Treatment Delay Following Breast-Conserving Surgery for Breast Cancer. Ann Surg Oncol 30, 8362–8370 (2023). https://doi.org/10.1245/s10434-023-14177-w

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