Expert Opinions on Postoperative Complications in Breast Cancer Surgery After Neoadjuvant Chemotherapy: A Descriptive Study Through Structured Interviews With Surgeons in Austria.

BACKGROUND

Neoadjuvant chemotherapy (NACT) is an important component in preparing breast cancer patients for surgery. Its impact on postoperative complications, such as wound infections and bleeding, remains unclear. While most studies show no increase in complication rates, factors such as smoking may elevate risk. Understanding surgeons' perspectives on bleeding and related influences is therefore essential.

METHODS

This study used a questionnaire on bleeding and wound healing. After ethical approval in Vienna and Burgenland, 33 surgeons were recruited. Data were collected between July and December 2022 through interviews or self-administered questionnaires and analyzed descriptively.

RESULTS

Overall, 63.6% of surgeons reported recognizing NACT-treated patients intraoperatively. Perceptions of blood loss varied, with some noting no difference and others reporting increased bleeding. The influence of tumor size and smoking was debated, with no clear consensus. Most surgeons did not observe prolonged operative times. Challenges in axillary dissection and sentinel lymph node identification were reported, particularly after NACT.

CONCLUSION

Surgeons' views on the impact of NACT in breast surgery vary considerably. These findings highlight the complexity of integrating NACT into surgical practice and the need for further research to improve training, patient counseling, and evidence-based guidelines.