Locally advanced breast cancer patients should be cautious about the immediate breast reconstruction after mastectomy: a pooling analysis of safety and efficacy

World J Surg Oncol. 2024 Jun 25;22(1):165. doi: 10.1186/s12957-024-03444-z.

Abstract

Background: The purpose of this study was to compare safety and efficacy outcomes between immediate breast reconstruction (IBR) and mastectomy alone in locally advanced breast cancer patients.

Methods: We conducted a comprehensive literature search of PUBMED, EMBASE, and Cochrane databases. The primary outcomes evaluated were overall survival, disease-free survival, and local recurrence. The secondary outcome was the incidence of surgical complications. All data were analyzed using Review Manager 5.3.

Results: Sixteen studies, involving 15,364 participants were included in this meta-analysis. Pooled data demonstrated that patients underwent IBR were more likely to experience surgical complications than those underwent mastectomy alone (HR: 3.96, 95%CI [1.07,14.67], p = 0.04). No significant difference was found in overall survival (HR: 0.94, 95%CI [0.73,1.20], p = 0.62), disease-free survival (HR: 1.03, 95%CI [0.83,1.27], p = 0.81), or breast cancer specific survival (HR: 0.93, 95%CI [0.71,1.21], p = 0.57) between IBR group and Non-IBR group.

Conclusions: Our study demonstrates that IBR after mastectomy does not affect the overall survival and disease-free survival of locally advanced breast cancer patients. However, IBR brings with it a nonnegligible higher risk of complications and needs to be fully evaluated and carefully decided.

Keywords: Immediate breast reconstruction; Locally advanced breast cancer; Meta-analysis; Overall survival; Surgical complication.

Publication types

  • Meta-Analysis

MeSH terms

  • Breast Neoplasms* / mortality
  • Breast Neoplasms* / pathology
  • Breast Neoplasms* / surgery
  • Female
  • Humans
  • Mammaplasty* / adverse effects
  • Mammaplasty* / methods
  • Mastectomy* / adverse effects
  • Mastectomy* / methods
  • Neoplasm Recurrence, Local / epidemiology
  • Neoplasm Recurrence, Local / etiology
  • Neoplasm Recurrence, Local / pathology
  • Postoperative Complications* / epidemiology
  • Postoperative Complications* / etiology
  • Prognosis
  • Survival Rate