Summary
Breast reconstruction following mastectomy has become, in many centers the standard
of care. An increasingly encountered trend is the use of neoadjuvant chemotherapy
to downstage high stage tumors and to decrease tumor burden prior to definitive oncologic
surgery. These agents clearly provide a survival benefit, but also have the potential
to adversely affect the surgical course of immediate and delayed breast reconstruction.
The use of new biologic and hormonal agents may also have effects on surgery and reconstruction.
Furthermore, chemotherapeutic agents as a whole may impair cellular functions necessary
for normal recovery from surgery. In this paper we present a concise review for the
reconstructive surgeon on adverse effects of chemotherapeutic, hormonal and biologic
agents used for treatment of breast cancer, important perioperative issues, and also
discuss their potential effect on breast reconstruction.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Plastic, Reconstructive & Aesthetic SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Adjuvant endocrine therapy in hormone receptor-positive postmenopausal breast cancer: evolution of NCCN, ASCO, and St Gallen recommendations.J Natl Compr Canc Netw. 2006; 4: 971-979
- Locally advanced and inflammatory breast cancer.J Clin Oncol. 2008; 26: 786-790
- Preoperative chemotherapy for women with operable breast cancer.Cochrane Database Syst Rev. 2007; 2: CD005002
- International expert panel on inflammatory breast cancer: consensus statement for standardized diagnosis and treatment.Ann Oncol. 2011; 22: 515-523
- Locoregional treatment of primary breast cancer: consensus recommendations from an International Expert Panel.Cancer. 2010; 116: 1184-1191
- Oncological aspects of breast reconstruction.Breast. 2005; 14: 118-130
- Recommendations from an international expert panel on the use of neoadjuvant (primary) systemic treatment of operable breast cancer: new perspectives 2006.Ann Oncol. 2007; 18: 1927-1934
- Does timing of adjuvant chemotherapy for early breast cancer influence survival?.J Clin Oncol. 2003; 21: 3792-3797
- NCCN task force report: adjuvant therapy for breast cancer.J Natl Compr Canc Netw. 2006; 4: S1-S26
- NCCN clinical practice guidelines in oncology: breast cancer screening and diagnosis.J Natl Compr Canc Netw. 2009; 7: 1060-1096
- NCCN task force report: estrogen receptor and progesterone receptor testing in breast cancer by immunohistochemistry.J Natl Compr Canc Netw. 2009; 7 (quiz S22–23): S1-S21
- Polychemotherapy for early breast cancer: an overview of the randomised clinical trials with quality-adjusted survival analysis.Lancet. 2001; 358: 277-286
- Trastuzumab plus adjuvant chemotherapy for operable HER2-positive breast cancer.N Engl J Med. 2005; 353: 1673-1684
- Four-year follow-up of trastuzumab plus adjuvant chemotherapy for operable human epidermal growth factor receptor 2-positive breast cancer: joint analysis of data from NCCTG N9831 and NSABP B-31.J Clin Oncol. 2011; 29: 3366-3373
- 2-year follow-up of trastuzumab after adjuvant chemotherapy in HER2-positive breast cancer: a randomised controlled trial.Lancet. 2007; 369: 29-36
- Estimating the magnitude of trastuzumab effects within patient subgroups in the HERA trial.Ann Oncol. 2008; 19: 1090-1096
- Comprehensive management of locally advanced breast cancer.Cancer. 1990; 66: 1387-1391
- Multidisciplinary therapy of locally far-advanced or inflammatory breast cancer with fixed perioperative sequence of epirubicin, vinorelbine, and fluorouracil chemotherapy, surgery, and radiotherapy: long-term results.Oncologist. 2006; 11: 563-573
- Recommendations from an international expert panel on the use of neoadjuvant (primary) systemic treatment of operable breast cancer: an update.J Clin Oncol. 2006; 24: 1940-1949
- Pharmacology.4th ed. Lippincott Williams & Wilkins, Philadelphia2009
- Influence of neoadjuvant chemotherapy on outcomes of immediate breast reconstruction.Plast Reconstr Surg. 2010; 126: 1-11
- Doxorubicin cardiomyopathy.Cardiology. 2010; 115: 155-162
- Pre-operative cardiac workup after anthracycline-based neoadjuvant chemotherapy. Is it really necessary?.Ann R Coll Surg Engl. Nov 18 2010;
- Protective effect of the bispiperazinedione ICRF-187 against doxorubicin-induced cardiac toxicity in women with advanced breast cancer.N Engl J Med. 1988; 319: 745-752
- ACC/AHA/ASE 2003 guideline update for the clinical application of echocardiography: summary article: a report of the American College of Cardiology/American heart association task force on practice guidelines (ACC/AHA/ASE Committee to update the 1997 guidelines for the clinical application of Echocardiography).Circulation. 2003; 108: 1146-1162
- Rocha Lima CM. 5-fluorouracil-induced coronary vasospasm.Cancer Control. 2004; 11: 46-49
- Non-Q-wave acute anterior myocardial infarction associated with 5-fluorouracil and cisplatin chemotherapy.South Med J. 2003; 96: 99
- Pulmonary drug toxicity: radiologic and pathologic manifestations.Radiographics. 2000; 20: 1245-1259
- Pulmonary infiltrates following administration of paclitaxel.Chest. 1996; 110: 289-292
- Fatal pulmonary fibrosis induced by paclitaxel: a case report and review of the literature.Int J Gynecol Cancer. 2006; 16: 391-393
- Methotrexate-induced liver cirrhosis. Clinical, histological and serological studies–a further 10-year follow-up.Dermatology. 1996; 192: 343-346
- Anticancer drug-induced kidney disorders.Drug Saf. Jan 2001; 24: 19-38
- Prevention of cisplatin nephrotoxicity: state of the art and recommendations from the European Society of clinical pharmacy special interest group on cancer Care.Cancer Chemother Pharmacol. 2008; 61: 903-909
- Estrogen and skin. An overview.Am J Clin Dermatol. 2001; 2: 143-150
- Anastrozole alone or in combination with tamoxifen versus tamoxifen alone for adjuvant treatment of postmenopausal women with early breast cancer: first results of the ATAC randomised trial.Lancet. 2002; 359: 2131-2139
- Neoadjuvant tamoxifen and aromatase inhibitors: comparisons and clinical outcomes.J Steroid Biochem Mol Biol. 2003; 86: 295-299
- Impact of chemotherapy regimens prior to endocrine therapy: results from the ATAC (Anastrozole and Tamoxifen, Alone or in Combination) trial.Cancer. 2006; 107: 472-480
- Coexpression of the type 1 growth factor receptor family members HER-1, HER-2, and HER-3 has a synergistic negative prognostic effect on breast carcinoma survival.Cancer. 2005; 103: 1770-1777
- Targeting signal transduction pathways in metastatic breast cancer: a comprehensive review.Oncologist. 2010; 15: 216-235
- Cardiac dysfunction in the trastuzumab clinical trials experience.J Clin Oncol. 2002; 20: 1215-1221
- Cardiac safety of lapatinib: pooled analysis of 3689 patients enrolled in clinical trials.Mayo Clin Proc. 2008; 83: 679-686
- Phase I safety, pharmacokinetics, and clinical activity study of lapatinib (GW572016), a reversible dual inhibitor of epidermal growth factor receptor tyrosine kinases, in heavily pretreated patients with metastatic carcinomas.J Clin Oncol. 2005; 23: 5305-5313
- HLA-DQA1*02:01 is a major risk factor for lapatinib-induced hepatotoxicity in women with advanced breast cancer.J Clin Oncol. 2011; 29: 667-673
- Timing of administration of bevacizumab chemotherapy affects wound healing after chest wall port placement.Cancer. 2011; 117: 1296-1301
- Paclitaxel plus bevacizumab versus paclitaxel alone for metastatic breast cancer.N Engl J Med. 2007; 357: 2666-2676
- Adverse effects of anticancer agents that target the VEGF pathway.Nat Rev Clin Oncol. 2009; 6: 465-477
- The impact of breast reconstruction on the delivery of chemotherapy.Cancer. 2010; 116: 1791-1800
- A comparison of surgical complications between immediate breast reconstruction and mastectomy: the impact on delivery of chemotherapy-an analysis of 391 procedures.Ann Surg Oncol. Jul 27 2011; ([Epub ahead of print])
- Wound complications in patients receiving adjuvant chemotherapy after mastectomy and immediate breast reconstruction for breast cancer.J Surg Oncol. 1994; 55: 194-197
- Immediate breast reconstruction after mastectomy for cancer.Br J Surg. 2000; 87: 1455-1472
- Immediate versus delayed reconstruction.Clin Plast Surg. 2007; 34: 39-50
- Concurrent adjuvant chemotherapy and immediate breast reconstruction with skin expanders after mastectomy for breast cancer.Breast Cancer Res Treat. 2000; 60: 267-275
- Effect of adjuvant systemic treatment on cosmetic outcome and late normal-tissue reactions after breast conservation.Acta Oncol. 2007; 46: 525-533
- Effect of preoperative chemotherapy on mastectomy for locally advanced breast cancer.Am Surg. 1990; 56: 6-11
- Randomized cooperative study of perioperative chemotherapy in breast cancer.J Clin Oncol. 1995; 13: 2712-2721
- Seroma formation following breast cancer surgery.Breast J. 2003; 9: 385-388
- Immediate autogenous breast reconstruction in clinically advanced disease.Plast Reconstr Surg. 1995; 95: 1039-1044
- Immediate breast reconstruction in patients with locally advanced disease.Ann Plast Surg. 1997; 38 (discussion 350–341): 345-349
- Immediate breast reconstruction with the TRAM flap after neoadjuvant therapy.Ann Plast Surg. 1999; 42: 240-244
- Impact of neoadjuvant chemotherapy on rate of tissue expander/implant loss and progression to successful breast reconstruction following mastectomy.Am J Surg. 2008; 196: 519-522
- Late results of breast reconstruction with free TRAM flaps: a prospective multicentric study.Plast Reconstr Surg. 1995; 95 (discussion 1205–1196): 1195-1204
- Predicting complications following expander/implant breast reconstruction: an outcomes analysis based on preoperative clinical risk.Plast Reconstr Surg. 2008; 121: 1886-1892
- Immediate microvascular breast reconstruction after neoadjuvant chemotherapy: complication rates and effect on start of adjuvant treatment.Ann Surg Oncol. 2010; 17: 2945-2950
- Complications after microvascular breast reconstruction: experience with 1195 flaps.Plast Reconstr Surg. Oct 2006; 118 (discussion 1110–1101): 1100-1109
- Impact of neoadjuvant chemotherapy on breast reconstruction.Cancer. 2011; 117: 2833-2841
- Complications after breast cancer surgery in patients treated with concomitant preoperative chemoradiation: a case-control analysis.Breast Cancer Res Treat. 2006; 95: 147-152
- New concept for immediate breast reconstruction for invasive cancers: feasibility, oncological safety and esthetic outcome of post-neoadjuvant therapy immediate breast reconstruction versus delayed breast reconstruction: a prospective pilot study.Breast Cancer Res Treat. 2010; 122: 439-451
- Postmastectomy morbidity after combination preoperative irradiation and chemotherapy for locally advanced breast cancer.World J Surg. 1993; 17 (discussion 242): 237-241
- Estrogen accelerates cutaneous wound healing associated with an increase in TGF-beta1 levels.Nat Med. 1997; 3: 1209-1215
- Estrogen promotes cutaneous wound healing via estrogen receptor beta independent of its antiinflammatory activities.J Exp Med. 2010; 207: 1825-1833
- Topical estrogen accelerates cutaneous wound healing in aged humans associated with an altered inflammatory response.Am J Pathol. 1999; 155: 1137-1146
- Selective estrogen receptor modulators accelerate cutaneous wound healing in ovariectomized female mice.Endocrinology. 2008; 149: 551-557
- Effects of tamoxifen on normal human dermal fibroblasts.Arch Facial Plast Surg. 2006; 8: 329-332
- Effect of tamoxifen on transforming growth factor beta1 production by keloid and fetal fibroblasts.Arch Facial Plast Surg. 2001; 3: 111-114
- The potential adverse effects of aromatase inhibitors on wound healing: in vitro and in vivo evidence.Expert Opin Drug Saf. 2009; 8: 523-535
- Concomitant use of tamoxifen with radiotherapy enhances subcutaneous breast fibrosis in hypersensitive patients.Br J Cancer. 2004; 91: 1251-1260
- Administration of tamoxifen in the perioperative period to patients with breast carcinoma prolongs axillary fluid drainage.Anticancer Res. 2000; 20: 1245-1248
- Risk factors influencing transfusion rates in DIEP flap breast reconstruction.Plast Reconstr Surg. 2011; 127: 1773-1782
- Skin reactions to the new biologic anticancer drugs.Curr Opin Support Palliat Care. 2009; 3: 294-299
- Antiangiogenic and antitumor effects of bevacizumab in patients with inflammatory and locally advanced breast cancer.J Clin Oncol. 2006; 24: 769-777
- A review on bevacizumab and surgical wound healing: an important warning to all surgeons.Ann Plast Surg. 2009; 62: 707-709
- Does neoadjuvant bevacizumab increase surgical complications in breast surgery?.Ann Surg Oncol. 2011; 18: 733-737
- Tamoxifen treatment and risk of deep venous thrombosis and pulmonary embolism: a Danish population-based cohort study.Cancer. 2009; 115: 4442-4449
- A multidisciplinary protocol for planned skin-preserving delayed breast reconstruction for patients with locally advanced breast cancer requiring postmastectomy radiation therapy: 3-year follow-up.Plast Reconstr Surg. 2011; 127: 2154-2166
- Cardiovascular effects of systemic cancer treatment.Cancer Treat Rev. Jun 2011; 37: 300-311
- Cyclophosphamide cardiotoxicity: an analysis of dosing as a risk factor.Blood. Nov 1986; 68: 1114-1118
Article info
Publication history
Published online: May 28, 2012
Accepted:
April 30,
2012
Received:
November 9,
2011
Identification
Copyright
© 2012 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Inc. All rights reserved.
