Incidence of postoperative complications in breast cancer patients depending on their tumor subtype and type of surgery

Abstract

Background. Breast cancer is distinguished by its heterogeneity. The biological subtype of the tumor influences the choice of treatment tactics, components of complex therapy. The appearance of targeted drugs made it possible to expand the indications of reconstructive plastic surgery in patients with breast cancer.Aim. To study the influence of the biological subtype of breast tumor on the frequency of complications after simultaneous and delayed reconstructive plastic surgeries.Materials and methods. The postoperative period of 577 patients 18–40 years with a diagnosis of stage I–IIIA unilateral breast cancer was studied. In 61.2 %, luminal cancer, subtype A, was verified, in 6.1 % – luminal cancer, subtype B, in 10.4 % – HER2-positive (luminal) ER+PR+, in 7.3 % – HER2-positive (non-luminal) ER–PR–, in 15 % – three times negative. All patients underwent surgical treatment, including, taking into account the indications and contraindications, in the volume of Madden mastectomy – 43.5 %, mastectomy with simultaneous two-stage reconstruction with silicone implants – 34.8 %, mastectomy with delayed two-stage reconstruction with silicone implants – 21.7 %.Results. In most patients, the early postoperative period was favorable, complications were recorded in 11.8 %: in 11.3 % of patients of group I, 11.4 % of group II, 11.7 % of group III, 14.3 % of group IV, 12.6 % of group V. After radical mastectomy, complications were recorded in 13.5 % of cases, after mastectomy with simultaneous and delayed reconstruction – in 10.4 %. The treatment efficacy rate was 65.2–84.6 %. Late postoperative complications were recorded in group I in 24.1 % of patients, in group II – in 22.9 %, in group III – in 23.3 %, in group IV – in 26.2 %, in group V – in 24.1 %. Among patients who underwent only radical mastectomy, complications were noted in 24.7 %, mastectomy with simultaneous reconstruction – in 24.9 %, mastectomy with delayed reconstruction – in 21.6 %. The treatment efficacy rate was 42.9–59.5 %.Conclusion. Our study did not reveal a relationship between the incidence of early and late postoperative complications in patients with different biological tumor types. Based on the literature, it can be assumed that not the type of tumor, but individually prescribed systemic therapy makes a significant contribution to the development of postoperative complications, which should be taken into account when planning reconstructive plastic surgeries.

Keywords

• biological subtype of tumor
• postoperative complications
• breast cancer
• reconstructive plastic surgery