Concurrent adjuvant chemotherapy and immediate breast reconstruction with skin expanders after mastectomy for breast cancer
Immediate breast reconstruction (IBR) by means of skin expander is currently one of the most widely used methods of breast reconstruction in mastectomized patients. However, given that many breast cancer patients usually receive adjuvant chemotherapy, the adoption of IBR raises new questions concern...
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| Veröffentlicht in: | Breast cancer research and treatment 2000-04, Vol.60 (3), p.267-275 |
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| creator | CAFFO, O CAZZOLLI, D NATALE, N AGUGIARO, S ECCHER, C GALLIGIONI, E SCALET, A ZANI, B AMBROSINI, G AMICHETTI, M BERNARDI, D BRUGNARA, S CIAGHI, G LUCENTI, A |
| description | Immediate breast reconstruction (IBR) by means of skin expander is currently one of the most widely used methods of breast reconstruction in mastectomized patients. However, given that many breast cancer patients usually receive adjuvant chemotherapy, the adoption of IBR raises new questions concerning possible cumulative toxicity. The present study reports our experience in the use of concurrent adjuvant chemotherapy and immediate breast reconstruction with skin expander after mastectomy for breast cancer and the acute cumulative toxicity of the treatments.
We evaluated a consecutive series of 52 breast cancer patients who have received IBR by skin expander after radical mastectomy and adjuvant chemotherapy concurrently during skin expansion between 1995 and 1998 (IBR/CT group). We identified two series of control patients treated during the same period: 51 consecutive patients undergoing radical mastectomy and IBR without adjuvant chemotherapy (IBR group) and 63 consecutive patients undergoing radical mastectomy and adjuvant chemotherapy without IBR (CT group). For each patient, we evaluated the incidence of surgical complications and chemotherapy's side effects and dose intensity.
The interval between surgery and the start of expander inflation was similar in IBR/CT (range 0-19, median 5 days) and IBR groups (range 0-40, median 5 days) and the timing of inflation was not influenced by chemotherapy. The overall incidence of surgical complications in patients undergoing IBR was low: seroma in eight cases, infection in one, skin necrosis in one, expander rupture in two and erythema in three. There were no statistically significant differences in the distribution of complications between the IBR/CT and IBR groups. The dose intensity of chemotherapy was similar between IBR/CT and CT groups, with a median dose intensity of 96% and 95% of the projected dose, respectively. The only statistically significant difference in terms of chemotherapy side effects (p = 0.03) was that stomatitis was more frequent and intense in the CT than in the IBR/CT group.
Concurrent treatment with IBR and adjuvant chemotherapy appears feasible and safe, it does not increase acute surgical complications or chemotherapy side effects, and does not require any changes in dose intensity or the timing of inflation. |
| doi_str_mv | 10.1023/A:1006401403249 |
| format | Article |
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We evaluated a consecutive series of 52 breast cancer patients who have received IBR by skin expander after radical mastectomy and adjuvant chemotherapy concurrently during skin expansion between 1995 and 1998 (IBR/CT group). We identified two series of control patients treated during the same period: 51 consecutive patients undergoing radical mastectomy and IBR without adjuvant chemotherapy (IBR group) and 63 consecutive patients undergoing radical mastectomy and adjuvant chemotherapy without IBR (CT group). For each patient, we evaluated the incidence of surgical complications and chemotherapy's side effects and dose intensity.
The interval between surgery and the start of expander inflation was similar in IBR/CT (range 0-19, median 5 days) and IBR groups (range 0-40, median 5 days) and the timing of inflation was not influenced by chemotherapy. The overall incidence of surgical complications in patients undergoing IBR was low: seroma in eight cases, infection in one, skin necrosis in one, expander rupture in two and erythema in three. There were no statistically significant differences in the distribution of complications between the IBR/CT and IBR groups. The dose intensity of chemotherapy was similar between IBR/CT and CT groups, with a median dose intensity of 96% and 95% of the projected dose, respectively. The only statistically significant difference in terms of chemotherapy side effects (p = 0.03) was that stomatitis was more frequent and intense in the CT than in the IBR/CT group.
Concurrent treatment with IBR and adjuvant chemotherapy appears feasible and safe, it does not increase acute surgical complications or chemotherapy side effects, and does not require any changes in dose intensity or the timing of inflation.</description><identifier>ISSN: 0167-6806</identifier><identifier>EISSN: 1573-7217</identifier><identifier>DOI: 10.1023/A:1006401403249</identifier><identifier>PMID: 10930115</identifier><identifier>CODEN: BCTRD6</identifier><language>eng</language><publisher>Dordrecht: Springer</publisher><subject>Adult ; Aged ; Antineoplastic agents ; Antineoplastic Combined Chemotherapy Protocols - therapeutic use ; Biological and medical sciences ; Breast cancer ; Breast Neoplasms - therapy ; Cancer research ; Cancer therapies ; Carcinoma in Situ - therapy ; Carcinoma, Ductal, Breast - therapy ; Carcinoma, Lobular - therapy ; Chemotherapy, Adjuvant ; Combined Modality Therapy ; Combined treatments (chemotherapy of immunotherapy associated with an other treatment) ; Female ; Humans ; Mammaplasty - methods ; Mastectomy, Radical ; Medical sciences ; Middle Aged ; Pharmacology. Drug treatments ; Tissue Expansion Devices ; Treatment Outcome</subject><ispartof>Breast cancer research and treatment, 2000-04, Vol.60 (3), p.267-275</ispartof><rights>2000 INIST-CNRS</rights><rights>Copyright Kluwer Academic Publishers Apr 2000</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c349t-1552032b6d8380f45bdf4ee004a19b699f3071950a6bc2a9b192c47f1d8960de3</citedby><cites>FETCH-LOGICAL-c349t-1552032b6d8380f45bdf4ee004a19b699f3071950a6bc2a9b192c47f1d8960de3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27923,27924</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1399021$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10930115$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>CAFFO, O</creatorcontrib><creatorcontrib>CAZZOLLI, D</creatorcontrib><creatorcontrib>NATALE, N</creatorcontrib><creatorcontrib>AGUGIARO, S</creatorcontrib><creatorcontrib>ECCHER, C</creatorcontrib><creatorcontrib>GALLIGIONI, E</creatorcontrib><creatorcontrib>SCALET, A</creatorcontrib><creatorcontrib>ZANI, B</creatorcontrib><creatorcontrib>AMBROSINI, G</creatorcontrib><creatorcontrib>AMICHETTI, M</creatorcontrib><creatorcontrib>BERNARDI, D</creatorcontrib><creatorcontrib>BRUGNARA, S</creatorcontrib><creatorcontrib>CIAGHI, G</creatorcontrib><creatorcontrib>LUCENTI, A</creatorcontrib><title>Concurrent adjuvant chemotherapy and immediate breast reconstruction with skin expanders after mastectomy for breast cancer</title><title>Breast cancer research and treatment</title><addtitle>Breast Cancer Res Treat</addtitle><description>Immediate breast reconstruction (IBR) by means of skin expander is currently one of the most widely used methods of breast reconstruction in mastectomized patients. However, given that many breast cancer patients usually receive adjuvant chemotherapy, the adoption of IBR raises new questions concerning possible cumulative toxicity. The present study reports our experience in the use of concurrent adjuvant chemotherapy and immediate breast reconstruction with skin expander after mastectomy for breast cancer and the acute cumulative toxicity of the treatments.
We evaluated a consecutive series of 52 breast cancer patients who have received IBR by skin expander after radical mastectomy and adjuvant chemotherapy concurrently during skin expansion between 1995 and 1998 (IBR/CT group). We identified two series of control patients treated during the same period: 51 consecutive patients undergoing radical mastectomy and IBR without adjuvant chemotherapy (IBR group) and 63 consecutive patients undergoing radical mastectomy and adjuvant chemotherapy without IBR (CT group). For each patient, we evaluated the incidence of surgical complications and chemotherapy's side effects and dose intensity.
The interval between surgery and the start of expander inflation was similar in IBR/CT (range 0-19, median 5 days) and IBR groups (range 0-40, median 5 days) and the timing of inflation was not influenced by chemotherapy. The overall incidence of surgical complications in patients undergoing IBR was low: seroma in eight cases, infection in one, skin necrosis in one, expander rupture in two and erythema in three. There were no statistically significant differences in the distribution of complications between the IBR/CT and IBR groups. The dose intensity of chemotherapy was similar between IBR/CT and CT groups, with a median dose intensity of 96% and 95% of the projected dose, respectively. The only statistically significant difference in terms of chemotherapy side effects (p = 0.03) was that stomatitis was more frequent and intense in the CT than in the IBR/CT group.
Concurrent treatment with IBR and adjuvant chemotherapy appears feasible and safe, it does not increase acute surgical complications or chemotherapy side effects, and does not require any changes in dose intensity or the timing of inflation.</description><subject>Adult</subject><subject>Aged</subject><subject>Antineoplastic agents</subject><subject>Antineoplastic Combined Chemotherapy Protocols - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Breast cancer</subject><subject>Breast Neoplasms - therapy</subject><subject>Cancer research</subject><subject>Cancer therapies</subject><subject>Carcinoma in Situ - therapy</subject><subject>Carcinoma, Ductal, Breast - therapy</subject><subject>Carcinoma, Lobular - therapy</subject><subject>Chemotherapy, Adjuvant</subject><subject>Combined Modality Therapy</subject><subject>Combined treatments (chemotherapy of immunotherapy associated with an other treatment)</subject><subject>Female</subject><subject>Humans</subject><subject>Mammaplasty - methods</subject><subject>Mastectomy, Radical</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Pharmacology. 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However, given that many breast cancer patients usually receive adjuvant chemotherapy, the adoption of IBR raises new questions concerning possible cumulative toxicity. The present study reports our experience in the use of concurrent adjuvant chemotherapy and immediate breast reconstruction with skin expander after mastectomy for breast cancer and the acute cumulative toxicity of the treatments.
We evaluated a consecutive series of 52 breast cancer patients who have received IBR by skin expander after radical mastectomy and adjuvant chemotherapy concurrently during skin expansion between 1995 and 1998 (IBR/CT group). We identified two series of control patients treated during the same period: 51 consecutive patients undergoing radical mastectomy and IBR without adjuvant chemotherapy (IBR group) and 63 consecutive patients undergoing radical mastectomy and adjuvant chemotherapy without IBR (CT group). For each patient, we evaluated the incidence of surgical complications and chemotherapy's side effects and dose intensity.
The interval between surgery and the start of expander inflation was similar in IBR/CT (range 0-19, median 5 days) and IBR groups (range 0-40, median 5 days) and the timing of inflation was not influenced by chemotherapy. The overall incidence of surgical complications in patients undergoing IBR was low: seroma in eight cases, infection in one, skin necrosis in one, expander rupture in two and erythema in three. There were no statistically significant differences in the distribution of complications between the IBR/CT and IBR groups. The dose intensity of chemotherapy was similar between IBR/CT and CT groups, with a median dose intensity of 96% and 95% of the projected dose, respectively. The only statistically significant difference in terms of chemotherapy side effects (p = 0.03) was that stomatitis was more frequent and intense in the CT than in the IBR/CT group.
Concurrent treatment with IBR and adjuvant chemotherapy appears feasible and safe, it does not increase acute surgical complications or chemotherapy side effects, and does not require any changes in dose intensity or the timing of inflation.</abstract><cop>Dordrecht</cop><pub>Springer</pub><pmid>10930115</pmid><doi>10.1023/A:1006401403249</doi><tpages>9</tpages></addata></record> |
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| subjects | Adult Aged Antineoplastic agents Antineoplastic Combined Chemotherapy Protocols - therapeutic use Biological and medical sciences Breast cancer Breast Neoplasms - therapy Cancer research Cancer therapies Carcinoma in Situ - therapy Carcinoma, Ductal, Breast - therapy Carcinoma, Lobular - therapy Chemotherapy, Adjuvant Combined Modality Therapy Combined treatments (chemotherapy of immunotherapy associated with an other treatment) Female Humans Mammaplasty - methods Mastectomy, Radical Medical sciences Middle Aged Pharmacology. Drug treatments Tissue Expansion Devices Treatment Outcome |
| title | Concurrent adjuvant chemotherapy and immediate breast reconstruction with skin expanders after mastectomy for breast cancer |
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