Abstract:

Objective

To evaluate the impact of neoadjuvant chemotherapy (NCT) on postoperative complications and efficacy after endoscopic mastectomy in breast cancer patients.

Methods

We retrospectively reviewed the clinical data of 183 breast cancer patients who underwent endoscopic modified mastectomy in our department from January 2007 to December 2010,in which 98 received NCT before surgery (NCT group) and 85 received endoscopic modified mastectomy directly (control group). The operation data (operation time,amount of bleeding,amount of drainage,rate of sentinel lymph node biopsy and lymph node metastasis),postoperative complications (infection,necrosis of nipple or skin flap and edema of upper extremities)and longterm efficacy (local recurrence,rate of distant metastasis and mortality) were compared between two groups.t test was used for measurement data,χ²test and Fisher’s exact probability test for count data.Then based on the follow-up time and deaths,the cumulative mortality curves were drawn.

Results

There were no significant differences in operation time,amount of bleeding,amount of drainage,rate of sentinel lymph node biopsy and lymph node metastasis between two groups(t=-0.381,1.468,-0.725,χ²=1.137,1.022;P=0.704,0.144,0.469,0.286,0.312). The rates of postoperative infection(P=0. 475),necrosis of nipple or skin flap and edema of upper extremities( χ²=0.005,1.117;P=0.946,0.291)showed no significantly statistical difference.Median follow-up time was 51 months(9 -77 months). The follow-up showed no significantly statistical difference between two groups in local recurrence(P=1. 000),distant metastasis rate and mortality ( χ² =0.123,0.009;P=0.726,0.925).

Conclusion

In breast cancer patients,NCT can not increase postoperative complications of endoscopic modified mastectomy,but the long-term efficacy will not be influenced by NCT.

Key words: Chemotherapy, adjuvant, Endoscopes, Breast neoplasms, Postoperative complications, Treatment outcome