Shammas RL, et al. - In this propensity score-matched analysis, researchers investigated for association between targeted HER-2 therapy and breast reconstruction outcomes. As per observations, trastuzumab therapy in conjunction with breast reconstructive operation seemed not related with reconstructive complications. Thus they suggest not delaying breast reconstruction due to the administration of trastuzumab. To evaluate the impact of pertuzumab on surgical outcomes, further studies were required.

Methods

• Researchers retrospectively identified women receiving chemotherapy and post-mastectomy reconstruction at Duke University Medical Center from 2006 to 2016.
• In this study, 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, with respect to the following factors: age, obesity, diabetes, tobacco use, receipt of neoadjuvant chemotherapy, chemotherapy regimen, and radiation therapy.
• The occurrence of hematoma, seroma, infection, wound breakdown, mastectomy skin flap necrosis, and postoperative flap thrombosis was assessed primarily.

Results

• Researchers identified 481 women, resulting in 107 propensity score-matched pairs.
• There appeared an independent association of administration of combined trastuzumab and pertuzumab therapy before breast reconstruction 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).
• Furthermore, larger tumor size (2 to 5 cm) seemed to have marked association 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 indicated no marked association with reconstructive complications.