The effect of immediate breast reconstruction on adjuvant chemotherapy.

Immediate breast reconstruction is being increasingly offered to patients requiring mastectomy for breast cancer. An audit was carried out to determine whether it affected time to initiation of chemotherapy, delays during chemotherapy, percentage intended dose and need for support with antibiotics or granulocyte-colony stimulating factor. A total of 44 patients undergoing a variety of reconstructive procedures followed by chemotherapy were identified and patient records were reviewed. These were compared with a control group of 49 patients undergoing mastectomy alone and chemotherapy in the same 4-year period and institution. Patients undergoing transverse rectus abdominis myocutaneous flap reconstruction experienced an average of 5 more days delay to chemotherapy initiation than controls with the commonest reason being poor wound healing. Percentage intended dose, delays during chemotherapy and need for support with granulocyte-colony stimulating factor or antibiotics were comparable in all groups.