Skip to main content
Journal cover image

Association Between Targeted HER-2 Therapy and Breast Reconstruction Outcomes: A Propensity Score-Matched Analysis.

Publication ,  Journal Article
Shammas, RL; Cho, EH; Glener, AD; Poveromo, LP; Mundy, LR; Greenup, RA; Blackwell, KL; Hollenbeck, ST
Published in: J Am Coll Surg
December 2017

BACKGROUND: Current treatment for HER-2+ breast cancer includes chemotherapy and targeted HER-2 therapy with trastuzumab and/or pertuzumab. Evidence is lacking on the safety of breast reconstructive operations in these patients. We hypothesized that targeted HER-2 therapy was not associated with post-mastectomy reconstructive outcomes. STUDY DESIGN: Women receiving chemotherapy and post-mastectomy reconstruction at Duke University Medical Center from 2006 to 2016 were retrospectively identified. Patients receiving targeted HER-2 therapy with trastuzumab and/or pertuzumab within 6 weeks before breast reconstruction were propensity score-matched 1:1 to patients who did not receive targeted HER-2 therapy, based on the following factors: age, obesity, diabetes, tobacco use, receipt of neoadjuvant chemotherapy, chemotherapy regimen, and radiation therapy. Primary study outcomes included the occurrence of hematoma, seroma, infection, wound breakdown, mastectomy skin flap necrosis, and postoperative flap thrombosis. RESULTS: A total of 481 women were identified, resulting in 107 propensity score-matched pairs. Administration of combined trastuzumab and pertuzumab therapy before breast reconstruction was independently associated with increased risk of postoperative wound breakdown requiring operative intervention for closure, compared with patients not undergoing targeted HER-2 therapy (odds ratio 65.29; 95% CI 1.63 to 2,611.50; p = 0.03). In addition, larger tumor size (2 to 5 cm) was significantly associated with a reduced risk of postoperative wound breakdown, compared with smaller tumors (<2 cm) (odds ratio 0.41; 95% CI 0.19 to 0.87; p = 0.02). Single-agent targeted HER-2 therapy with trastuzumab was not significantly associated with reconstructive complications. CONCLUSIONS: Our study suggests that trastuzumab therapy in conjunction with breast reconstructive operation is not associated with reconstructive complications, and breast reconstruction does not need to be delayed due to the administration of trastuzumab. Future studies are needed to evaluate the impact of pertuzumab on surgical outcomes.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

J Am Coll Surg

DOI

EISSN

1879-1190

Publication Date

December 2017

Volume

225

Issue

6

Start / End Page

731 / 739.e1

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Trastuzumab
  • Surgery
  • Retrospective Studies
  • Receptor, erbB-2
  • Receptor, ErbB-2
  • Propensity Score
  • Molecular Targeted Therapy
  • Middle Aged
  • Mammaplasty
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Shammas, R. L., Cho, E. H., Glener, A. D., Poveromo, L. P., Mundy, L. R., Greenup, R. A., … Hollenbeck, S. T. (2017). Association Between Targeted HER-2 Therapy and Breast Reconstruction Outcomes: A Propensity Score-Matched Analysis. J Am Coll Surg, 225(6), 731-739.e1. https://doi.org/10.1016/j.jamcollsurg.2017.08.023
Shammas, Ronnie L., Eugenia H. Cho, Adam D. Glener, Luke P. Poveromo, Lily R. Mundy, Rachel A. Greenup, Kimberly L. Blackwell, and Scott T. Hollenbeck. “Association Between Targeted HER-2 Therapy and Breast Reconstruction Outcomes: A Propensity Score-Matched Analysis.J Am Coll Surg 225, no. 6 (December 2017): 731-739.e1. https://doi.org/10.1016/j.jamcollsurg.2017.08.023.
Shammas RL, Cho EH, Glener AD, Poveromo LP, Mundy LR, Greenup RA, et al. Association Between Targeted HER-2 Therapy and Breast Reconstruction Outcomes: A Propensity Score-Matched Analysis. J Am Coll Surg. 2017 Dec;225(6):731-739.e1.
Shammas, Ronnie L., et al. “Association Between Targeted HER-2 Therapy and Breast Reconstruction Outcomes: A Propensity Score-Matched Analysis.J Am Coll Surg, vol. 225, no. 6, Dec. 2017, pp. 731-739.e1. Pubmed, doi:10.1016/j.jamcollsurg.2017.08.023.
Shammas RL, Cho EH, Glener AD, Poveromo LP, Mundy LR, Greenup RA, Blackwell KL, Hollenbeck ST. Association Between Targeted HER-2 Therapy and Breast Reconstruction Outcomes: A Propensity Score-Matched Analysis. J Am Coll Surg. 2017 Dec;225(6):731-739.e1.
Journal cover image

Published In

J Am Coll Surg

DOI

EISSN

1879-1190

Publication Date

December 2017

Volume

225

Issue

6

Start / End Page

731 / 739.e1

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Trastuzumab
  • Surgery
  • Retrospective Studies
  • Receptor, erbB-2
  • Receptor, ErbB-2
  • Propensity Score
  • Molecular Targeted Therapy
  • Middle Aged
  • Mammaplasty