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HER2-Targeted Therapy and Breast Reconstruction

By: Bruce Cleary
Posted: Thursday, October 26, 2017

In reportedly the first study of its kind, Shammas et al, of Duke University Medical Center, suggested that using the HER2-targeted agent trastuzumab does not appear to be associated with postmastectomy reconstructive complications. However, combination therapy with trastuzumab and pertuzumab may increase the risk for wound complications immediately after breast reconstruction, and further study of the impact of pertuzumab on surgical outcomes is needed. These findings were published in the Journal of the American College of Surgeons.

“If a patient is otherwise fairly healthy and the surgery is straightforward, immediate breast reconstruction may be done even if she is receiving both therapies,” commented principal study author Scott T. Hollenbeck, MD, FACS, a plastic and reconstructive surgeon at Duke, in a press release from the American College of Surgeons. “If a patient has other risk factors and faces a potentially difficult operation, I would recommend waiting until the completion of pertuzumab therapy.”

The investigators focused on 481 women who had breast reconstruction following mastectomy at Duke from 2006 through 2016. Although single-agent therapy with trastuzumab was not linked to reconstruction complications, the combination of trastuzumab and pertuzumab before breast reconstruction was associated with an increased risk of wound breakdown after surgery requiring operative closure.