Impact of Major Systemic Infections on Breast Cancer Recurrence and Survival
Overview
This nationwide cohort study of 82,102 breast cancer surgery patients found that major systemic infections within 90 days post-surgery significantly increase the risk of distant recurrence, overall mortality, and breast cancer-specific mortality. Other major events such as stroke, myocardial infarction, and pulmonary embolism showed no significant association with recurrence.
Background
Postoperative infections are common complications after cancer surgery and have been linked to poorer oncological outcomes in various cancers. The immunosuppressive effects of surgery and subsequent inflammation may promote cancer recurrence by stimulating micrometastases. While prior studies on breast cancer have yielded conflicting results regarding surgical site infections, the impact of major systemic infections on breast cancer outcomes has not been thoroughly investigated.
Data Highlights
Parameter
Incidence
Hazard Ratio (HR)
95% Confidence Interval
Major systemic infection (within 90 days)
1.8% (1461/82,102)
1.23
1.07–1.41 (distant recurrence)
Other major events (stroke, MI, PE)
0.6% (516/82,102)
Not significant
Overall death (major systemic infection)
1.47
1.32–1.64
Breast cancer-specific death (major systemic infection)
Major systemic infections within 90 days post-breast cancer surgery occurred in 1.8% of patients and were associated with a 23% increased risk of distant recurrence.
Major systemic infections increased overall mortality risk by 47% and breast cancer-specific mortality by 27%.
No significant association was found between major systemic infections and locoregional recurrence.
Other major postoperative events (stroke, myocardial infarction, pulmonary embolism) were not significantly linked to breast cancer recurrence.
The median follow-up period was 4.8 years, supporting the robustness of long-term outcome assessment.
Clinical Implications
Clinicians should prioritize prevention, early detection, and effective management of major systemic infections following breast cancer surgery to potentially reduce the risk of distant recurrence and improve survival outcomes. Awareness of the immunosuppressive and inflammatory consequences of systemic infections underscores the need for vigilant postoperative care. These findings highlight the importance of multidisciplinary strategies to mitigate infection-related risks in breast cancer patients.
Conclusion
Major systemic postoperative infections significantly increase the risk of distant breast cancer recurrence and mortality, emphasizing the critical role of infection control in optimizing oncological outcomes after breast cancer surgery.
References
Original Article 2024 -- Impact of Significant Systemic Infections on Oncological Results After Breast Cancer Surgery
