Neoadjuvant bevacizumab: surgical complications of mastectomy with and without reconstruction

• Published in: Breast cancer research and treatment Vol. 141; no. 2; pp. 255 - 259
• Main Authors: Kansal, Kari Joanne, Dominici, Laura Stewart, Tolaney, Sara M., Isakoff, Steven J., Smith, Barbara L., Jiang, Wei, Brock, Jane E., Winer, Eric P., Krop, Ian E., Golshan, Mehra
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01.09.2013; Springer; Springer Nature B.V
• Subjects: Adult; Aged; Angiogenesis inhibitors; Angiogenesis Inhibitors - administration & dosage; Angiogenesis Inhibitors - therapeutic use; Antibodies, Monoclonal, Humanized - administration & dosage; Antibodies, Monoclonal, Humanized - therapeutic use; Antineoplastic Agents - administration & dosage; Antineoplastic Agents - therapeutic use; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Bevacizumab; Biological and medical sciences; Breast cancer; Breast Neoplasms - drug therapy; Breast Neoplasms - pathology; Breast Neoplasms - surgery; Cancer; Cancer research; Cancer therapies; Chemotherapy; Clinical Trial; Clinical trials; Complications and side effects; Female; Gynecology. Andrology. Obstetrics; Humans; Mammaplasty; Mammary gland diseases; Mastectomy; Mastectomy - adverse effects; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); Neoadjuvant Therapy; Neoplasm Staging; Oncology; Postoperative Complications; Surgery; Surgical outcomes; Treatment Outcome; Tumors; Young Adult; Neoadjuvant chemotherapy; Mastectomy; HER2-negative breast cancer; Breast cancer; Postoperative complications; Bevacizumab; Antineoplastic agent; Postoperative; Breast disease; erbB2 Gene; Monoclonal antibody; Malignant tumor; Neoadjuvant treatment; Human Epidermal growth factor Receptor 2; Mammary gland diseases; Chemotherapy; Treatment; Vascular endothelium growth factor; Surgery; C-Onc gene; Complication; Antiangiogenic agent; Protooncogene; Cancer
• ISSN: 0167-6806; 1573-7217
• DOI: 10.1007/s10549-013-2682-z

Neoadjuvant therapy (NAC) is commonly used in operable breast cancer. Previous studies have suggested a high rate of postoperative complications after NAC. We prospectively evaluated the surgical complications in a cohort of patients who underwent mastectomy following neoadjuvant adriamycin/cytoxan/taxol (AC/T) plus bevacizumab (bev) and compared the rate of complications to a matched cohort of neoadjuvant AC/T without bev. One hundred patients with HER2-negative breast cancer enrolled in a single-arm trial of neoadjuvant AC/T plus bev (cohort 1), 60 of these patients underwent mastectomy and were matched with 59 patients who received standard neoadjuvant AC/T (cohort 2) over a similar time period in the same healthcare system. All patients underwent mastectomy with or without reconstruction. Fisher’s exact tests were used to compare complication rates, with p  < 0.05 considered significant. Patients were matched well in terms of demographics. The overall complication rate was 32 % in cohort 1 and 31 % in cohort 2 ( p value = 1, Table  1 ). In cohort 1, 7 of 23 (30 %) patients who underwent immediate expander/implant reconstruction had complications, including 2 patients who had explantation of their reconstructions. In cohort 2, 0 of 8 (0 %) had complications ( p value = 0.15). Nearly a third of patients undergoing NAC with AC/T with or without bev developed a postoperative complication after mastectomy. The use of bev was not associated with a significant increase in surgical complications, although this is a nonrandomized data set with a small sample size. As larger data sets become available with the use of neoadjuvant bevacizumab with mastectomy, further refinement may be necessary.