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Invited Critique
September 2010

Chemotherapy and Breast ReconstructionComment on “Impact of Chemotherapy on Postoperative Complications After Mastectomy and Immediate Breast Reconstruction”

Author Affiliations

Author Affiliation: Department of Surgery, John Wayne Cancer Institute at Saint John's Health Center, Santa Monica, California.

Arch Surg. 2010;145(9):885. doi:10.1001/archsurg.2010.167

This study examines the impact of chemotherapy on complications after 163 consecutive mastectomies with immediate reconstruction. The authors examine the infection rate, reoperative rate, prosthesis loss, skin necrosis, hematoma, donor-site complications, and flap loss. The overall complication rate of more than 30% is high for an elective procedure, and many of these complications are very difficult to determine retrospectively and may be underestimated. Some, however, are not, such as reoperation or prosthesis loss. The authors report a statistically significant increased infection rate among patients who received postoperative adjuvant chemotherapy but not neoadjuvant chemotherapy.

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