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Category: Volume 05 Issue 10 October 2017
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Title: Impact of Neoadjuvant Chemotherapy on Wound Healing in Modified Radical Mastectomy

Authors: Dr Kaushik.R, Dr Arulappan, Dr Karthik Balaji, Dr Sivaraja, Dr Kishan Rao

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i10.204

Abstract

Introduction: Breast cancer is the second most common cancer among females in India. Neoadjuvant chemotherapy is the standard of care for patients with LABC but its effect on post operative wound healing is debatable.

Aim: In this study we aimed to analyze the wound problems in patients undergoing modified radical mastectomy following neoadjuvant chemotherapy in comparison with patients undergoing primary modified radical mastectomy in terms of wound infection, seroma, flap necrosis, wound dehiscence, and delay in initiation /restarting chemotherapy post surgery.

Materials and Methods: We prospectively analyzed 60 patients undergoing modified radical mastectomy following neoadjuvant chemotherapy in comparison with patients undergoing primary modified radical mastectomy for carcinoma breast with 30 in each arm from june 2014 to September 2016. All patients in the neoadjuvant chemotherapy arm received 4 cycles of Inj. Adriamycin 60mg/m2, Inj.Cyclophosphamide 600mg/m2. Variables analysed include wound infection, seroma, flap necrosis, wound dehiscence, and delay in initiation /restarting chemotherapy post surgery. Sub analyses of the other tumor and patient factors which impact wound healing was done.

Results: In our study none of the variables analysed were statistically significant. The sub analysis of number of nodes removed and seroma formation, patient factors like BMI and diabetes showed statistical significance.

Conclusion: With the limitation of a small sample size the study concluded that the rate of wound complications in modified radical mastectomy following neoadjuvant chemotherapy is not significantly different from that of primary modified radical mastectomy.

Keywords: Locally advanced, neoadjuvant, chemotherapy, chemoradiation. retrospective.

References

  1. C.Concise clinical oncology. Elsevier Health Sciences;2005,P 144
  2. Guinea VF: epidemiology of breast cancer in blind KI, Copeland EM, (iii edition) the breast : Comprehensive management of benign and malignant disease, Philadelphia WB Saunder 1998 P 339
  3. Jamal A, Murray T Samuels A, Ghafoor A, Ward E, thunM. Cancer statistics, 2003.CA cancer J Clin 2003;53(1); 5-26
  4. Hortobagyi GN, Singletary SE Strom EA. Treatment of locally advanced and inflammatory breast cancer .Diseases of the breast 2nd edition Filadelfia: lippinocott, Williams and Wilkins.2000; 334-345
  5. Valgussa P Zametti et al Factors affecting results in combined modality of treatment , clinical exp metastasis 1983-1.191
  6. Swain SM. Sorace neoadjuvant chemotherapy in combined modality approach in LABC, Cancer Research 1987:447:3889
  7. Calais G, Berger C, Descamps et al Conservative treatment feasibility with induction chemotherapy, surgery and radiotherapy for patient with breast cancer larger than 3 cm 1994;74,1785 1788
  8. De Lena M Varini M, Zucali R, Rovini d, Viganotto G, Valagussa P,Multimodal treatment for locally advanced breast cancer. Result of chemotherapy –radiotherapy versus chemotherapy surgery. Cancer clinical trials 1980 Dec;4(3):229-36
  9. Singletary SE MC Neese MD Hortobagyi Feasibility ofBCS after inductionche-motherapy, LABC cancere 1992, 69-2849-2852
  10. Schwartz GF Birchansky et al ; induction chemotherapy followed by breast conservation for LABC cancer 1994 73 362-369

Corresponding Author

Dr Kaushik.R