The impact of chemotherapy-induced neutropenia on the outcome of direct-to-implant immediate breast reconstruction.

Background: Adjuvant chemotherapy can cause neutropenia by inhibition of hematopoiesis. However, little information is known about the effects of chemotherapy-induced neutropenia (CIN) on the outcomes of direct-to-implant (DTI) immediate breast reconstruction after skin-sparing mastectomy.

Methods: A retrospective review was performed for all patients with DTI immediate breast reconstruction after skin-sparing mastectomy (n=372) between January 2011 and December 2019. The demographic and complication of patients who experienced CIN during chemotherapy and those who did not were compared.

Results: Major infection requiring surgical management occurred in 4 patients (7.1%) in the CIN group (n=56) and 2 (3.6%) in the non-CIN group (n=55). Minor infection requiring antibiotics treatment occurred in 1 patient (1.8%) in the CIN group and 1 (1.8%) in the non-CIN group. Skin necrosis occurred in 7 patients (12.5%) in CIN group and 11 patients (19.6%) in non-CIN group. There were no significant difference in incidence of all complications between two groups.

Conclusions: CIN may not significantly increase the incidence of severe complications in the patients who received adjuvant chemotherapy after DTI immediate breast reconstruction. However, close observation is required for possible breast complication and adequate treatment is needed.