Time Interval Between Neoadjuvant Chemotherapy Completion and Mastectomy is Not Associated with 30-Day Complication Rate.

Authors

Lilia G Lunt, Tanya L Hoskin, Amy C Degnim, Carrie A Olson, Milissa M Klebe, Rachel E Marden, Judy C Boughey

Published in

Annals of surgical oncology. Jul 23, 2026. Epub Jul 23, 2026.

Abstract

The optimal interval between neoadjuvant chemotherapy (NAC) and breast surgery remains unclear. We evaluated whether time to surgery (TTS) affects 30-day postoperative complications.
Review was performed of all women undergoing mastectomy with or without reconstruction following NAC at a single institution between 2014-2024. The 30-day postoperative complications were analyzed by TTS using chi-squared tests for univariate analysis and logistic regression for multivariable analysis.
A total of 862 patients were identified with mastectomy following NAC with a median age of 49 (range 22-86) years, and 30-day complications occurred in 54 patients (6.3%, 95% CI 4.8-8.1%), including hematoma (n = 11), surgical site infection (n = 19), necrosis (n = 19), thromboembolism (n = 3), and C. difficile infection (n = 2). 30-day surgical complications were not different between those treated with immunotherapy (4.3%) versus without (6.4%, p = 0.79). TTS was 20-62 days in 90% of patients. Median TTS was 32 (IQR 27-40) days, which did not differ between patients with and without a complication (p = 0.85). Adjusting for age, smoking, type of mastectomy, and surgery year on multivariable analysis, there was no significant association between TTS and 30-day surgical complications (adjusted OR for TTS ≤ 32 days versus > 32 days 1.30, 95% CI 0.75-2.29, p = 0.35). Recurrence-free survival was similar between patients with TTS ≤ 32 days versus > 32 days, both overall (78.9% versus 80.7% at 5 years, p = 0.29) and when stratified by residual cancer burden and tumor biology.
TTS between 3 and 9 weeks after NAC was not associated with higher 30-day clinically significant complications. These findings support reasonable scheduling flexibility, but they do not establish safety of very early or delayed surgery outside this window.

PMID:
42489984
Bibliographic data and abstract were imported from PubMed on 23 Jul 2026.

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