Abstract: Surgical Site Infection in Immediate Breast Reconstruction: Does Chemotherapy Timing Make a Difference?

BACKGROUND AND OBJECTIVES We aim to analyze the impact of chemotherapy timing on surgical site infections (SSI) after immediate breast reconstruction (IBR). METHODS A retrospective review of patients undergoing IBR between 2010 and 2015 was performed. Patients were divided into four groups: those with neoadjuvant chemotherapy only, adjuvant chemotherapy only, both adjuvant and neoadjuvant, and those with no chemotherapy. Outcomes of interest included SSI and timing of post-operative SSI. RESULTS A total of 949 reconstructions were performed over the study period. Subgroup breakdown was as follows: A total of 56 (5.9%) neoadjuvant only, 173 (18.2%) adjuvant only, 18 (1.9%) both, and 702 (74.0%) none. Overall infection rates were 10.7%, 10.4%, 22.2%, and 6.1% in the four groups, respectively (P = 0.015). On multivariate analysis, no significant differences were observed when comparing presence or absence of chemotherapy in the overall reconstruction cohort or when subgrouped by reconstruction modality-autologous or alloplastic. There were no significant differences in time from neoadjuvant chemotherapy to surgery date noted between patients who developed a post-operative SSI and those who did not (4.40 ± 1.58 vs 4.72 ± 1.39 weeks; P = 0.517). CONCLUSION Chemotherapy timing did not increase the odds of surgical site infections in patients undergoing immediate breast reconstruction.