Bridging Safety and Efficacy; Neoadjuvant Chemotherapy Has Stable Complication Rates in Patients Treated With Oncoplastic Breast Surgery.

Abstract

Background: Breast-conserving surgery may be achieved following neoadjuvant chemotherapy (NACT) through oncoplastic breast surgery techniques. However, concerns have been raised regarding NACT and its possibility of increasing postoperative complications after oncoplastic procedures. This study evaluates whether NACT increases postoperative complications in patients with breast cancer undergoing oncoplastic surgery compared to upfront surgery.

Methods: A retrospective analysis was conducted on 306 patients who underwent oncoplastic breast conserving surgery at Assiut University Hospital between January 2018 and December 2022. Patients who received neoadjuvant chemotherapy (NACT) compared to those who underwent upfront surgery, while comparing demographic characteristics, postoperative complications with risk factors for both groups.

Results: The study included 306 patients, of these patients, 210 patients received NACT compared to 96 patients who underwent upfront surgery. No significant differences in demographic data were found between the 2 groups. The postoperative complications were similar across both groups. No considerable differences were found between NACT and upfront surgery groups in wound gapping (aOR 0.92 and p = 0.873), infection (aOR 0.90 and p = 0.846), breast seroma (aOR 0.95 and p = 0.901), axillary seroma (aOR 1.27 and p = 0.69), nipple areola complex (NAC) ischemia (aOR 0.65 and p = 0.644), fat necrosis (aOR 1.05 and p = 0.925), hypertrophic scarring (aOR 0.96 and p = 0.901), radiation mastitis (aOR 0.89 and p = 0.862), or loss of NAC sensation (aOR 0.97 and p = 0.929).

Conclusions: NACT does not increase complication rates in OBCS, supporting its safety in patients with breast cancer. These findings direct treatment planning and patient counseling.