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A retrospective study was done to evaluate the frequency and severity of wound complications in 112 patients with breast cancer who received adjuvant chemotherapy following mastectomy with immediate breast reconstruction. Data on wound complications were available for 120 mastectomies. The rate of complications in 36 mastectomies treated with chemotherapy after mastectomy and immediate reconstruction was compared to that in 84 mastectomies not receiving adjuvant therapy. There were 25 wound complications (20.8%) in the entire group. The rate of wound complications was 27.8% (10 of 36 mastectomies) in the group treated with adjuvant chemotherapy and 17.9% (15 of 84 mastectomies) in the group that did not receive adjuvant therapy (P = 0.13). No patient had a delay in the initiation of adjuvant therapy because of wound complications secondary to immediate reconstruction. Logistic regression analysis found no correlation between age, type of operation, tumor pathology, stage, number of lymph nodes harvested, type of prosthesis or chemotherapy, and wound complications in patients undergoing immediate breast reconstruction after mastectomy. The frequency of wound complications was not increased in patients receiving adjuvant chemotherapy after mastectomy and immediate breast reconstruction. The administration of adjuvant chemotherapy does not need to be delayed in patients who have had immediate breast reconstruction following mastectomy for breast cancer.