Postoperative Complications following Lumpectomy and Mastectomy in Women with Pregnancy Associated Breast Cancer

Abstract Purpose: This study aimed to delineate postoperative complications following lumpectomy and mastectomy in women with pregnancy associated breast cancer (PABC).Methods: This is a single institution retrospective study of 74 patients with PABC treated with lumpectomy (n=28) or mastectomy (n=46). Patient demographics, presentation, tumor characteristics, staging, genetic testing, and postoperative complications were recorded. Results: PABC was diagnosed in 74 patients; 28 (37.8%) were diagnosed with PABC during pregnancy (PABC-P) and 46 patients (62.2%) were diagnosed with postpartum PABC within the first 12 months after delivery (PABC-PP). The overall clinical stage distribution at diagnosis was: Stage 0, 6.9%; I, 18.1%; II, 47.2%; III, 22.2%; and IV, 5.6%, with no significant difference between PABC-P and PABC-PP (p=0.18). There was no significant difference in the rate of lumpectomy (25.0% vs 23.9%, p=0.92), mastectomy (75.0% vs 76.1%, p=0.92), sentinel lymph node biopsy (39.3% vs 52.2%, p=0.28), axillary dissection (14.3% vs 4.3%, p=0.19), or rate of immediate reconstruction (42.9% vs 65.7%, p = 0.094) performed in patients with PABC-P and PABC-PP, respectively. Contralateral prophylactic surgery was performed in 43.2% of patients (39.3% PABC-P vs 47.5% PABC-PP, p=0.59). Most (79.9%) patients did not experience any postoperative complications, regardless of whether they underwent lumpectomy or mastectomy (83.3% vs 78.6%, p=0.99) or if they had PABC-P or PABC-PP (89.3% vs 73.9%, p=0.11). There was a statistically significant difference in the rate of complications between PABC-P patients undergoing mastectomy with immediate reconstruction (n=0/9, 0%) as compared to the PABC-PP patients (n=9, 39%; p=0.035). Seroma was the most commonly observed complication after both lumpectomy and mastectomy (n=3 vs n=5, p=0.39). Conclusions: There was no increased risk of postoperative complications in women with PABC treated with lumpectomy as compared to mastectomy. There is an increased risk of postoperative complications in patients with PABC-PP treated with mastectomy and immediate reconstruction.