Postoperative Outcomes following a Multidisciplinary Approach to HIV-positive Breast Cancer Patients.

Autor:	Sayyed AA; Georgetown University School of Medicine, Washington D.C.; Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington D.C., Shin S; Georgetown University School of Medicine, Washington D.C., Abu El Hawa AA; Division of Plastic and Reconstructive Surgery, Icahn School of Medicine at Mount Sinai, N.Y., Sogunro O; Department of Surgery, Johns Hopkins Hospital, Baltimore M.D., Del Corral GA; Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington D.C., Boisvert ME; Department of Surgery, MedStar Washington Hospital Center, Washington D.C., Song DH; Department of Plastic and Reconstructive Surgery, MedStar Georgetown University Hospital, Washington D.C.
Jazyk:	angličtina
Zdroj:	Plastic and reconstructive surgery. Global open [Plast Reconstr Surg Glob Open] 2022 Sep 28; Vol. 10 (9), pp. e4552. Date of Electronic Publication: 2022 Sep 28 (Print Publication: 2022).
DOI:	10.1097/GOX.0000000000004552
Abstrakt:	Improvements in human immunodeficiency virus (HIV) treatment resulted in drastic increases in the lifespan of HIV-positive individuals, resulting in higher rates of non-AIDS-defining cancers. We describe our postoperative outcomes in HIV+ breast cancer (BC) patients, highlighting our multidisciplinary experience with this high-risk population. Methods: A 7-year multi-institutional retrospective review of all HIV+ BC patients who underwent surgical intervention was performed. Patient demographics, therapeutic interventions, and treatment outcomes were collected. Results: Twenty-four patients were identified, including one male patient (4.2%). Most patients were African American (83.3%). Mean age was 52.1 + 9.7 years at the time of diagnosis in HIV+ BC patients. Surgical interventions included lumpectomy (n = 16, 66.7%), simple mastectomy (n = 3, 12.5%), and skin-sparing mastectomy (n = 5. 20.8%). All patients were on antiretroviral therapy, and 81.3% had undetectable viral loads at the time of operation. Seventeen patients (70.8%) underwent breast reconstruction, with three (17.7%) undergoing delayed reconstruction. Thirty-day postoperative complications occurred in three patients (17.6%), including flap necrosis (11.8%), infection (11.8%), dehiscence (5.9%), and return to OR (11.8%). Three patients (12.5%) experienced recurrence at a median of 18 months since operation. Mean follow-up was 51.4 + 33.3 months since BC diagnosis. Conclusions: While postoperative complication rates in HIV+ patients trended higher (17.6%) compared with the existing data on breast reconstruction patients overall (10.1%), HIV+ patients did not exhibit increased risk of BC recurrence (12.5%) compared with BC patients overall (12-27%). This highlights the importance of a combined multidisciplinary approach involving infectious disease, breast surgery, and plastic and reconstructive surgery to optimize surgical and oncologic outcomes in these high-risk patients. (Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons.)
Databáze:	MEDLINE
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