Postoperative complications after breast-conserving surgery in breast cancer patients were associated with delays in adjuvant therapy, while higher body mass index (BMI) and socioeconomic distress were linked to increased complication risk in initial analyses, according to a study published in The Breast Journal.
Researchers analyzed data from 627 patients who underwent breast-conserving surgery (BCS) between 2016 and 2022 at a single institution in the Bronx. While BCS is typically regarded as a low-morbidity procedure, researchers found that 15.4% of participants experienced postoperative complications. Patients who developed complications were more likely to experience delays in starting adjuvant treatments — such as radiation, chemotherapy, or endocrine therapy.
The study cohort was predominantly composed of ethnic minority patients from socioeconomically distressed communities, providing a look at how social determinants of health influence surgical recovery. Persistent pain, the most common complication, showed significant variation by ethnicity: Hispanic patients accounted for 60.2% of cases, followed by African American (21.6%), white (10.2%) and Asian (3.4%) patients.
While initial analyses indicated that higher socioeconomic distress — measured by the Distressed Communities Index (DCI) — was linked to increased complication risk, this association was not found to be independent of other clinical risk factors in the final model.
Factors linked to a higher risk of complications included former smoking (3.44 times higher risk), hypertension (3.85 times higher risk), and receipt of adjuvant chemotherapy (2.76 times higher risk).
Among patients receiving adjuvant therapy, 6.3% experienced delays in treatment initiation. Patients who developed postoperative complications were more than six times as likely to experience such delays compared with those without complications.
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“These findings suggest that individuals in more distressed communities, or with lower socioeconomic status, or of an ethnic minority, may be correlated with a higher risk in terms of cancer progression,” the researchers wrote.
The authors noted that addressing modifiable risk factors, such as smoking and hypertension, and reducing delays between surgery and adjuvant therapy may help improve outcomes.
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