Breast cancer recurrence after immediate and delayed postmastectomy breast reconstruction—A systematic review and meta‐analysis
Background Oncological safety of different types and timings of PMBR after breast cancer remains controversial. Lack of stratified risk assessment in literature makes current clinical and shared decision‐making complex. This is the first systematic review and meta‐analysis to evaluate differences in...
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| Veröffentlicht in: | Cancer 2022-10, Vol.128 (19), p.3449-3469 |
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| creator | Bargon, Claudia A. Young‐Afat, Danny A. Ikinci, Mehmet Braakenburg, Assa Rakhorst, Hinne A. Mureau, Marc A.M. Verkooijen, Helena M. Doeksen, Annemiek |
| description | Background
Oncological safety of different types and timings of PMBR after breast cancer remains controversial. Lack of stratified risk assessment in literature makes current clinical and shared decision‐making complex. This is the first systematic review and meta‐analysis to evaluate differences in oncological outcomes after immediate versus delayed postmastectomy breast reconstruction (PMBR) for autologous and implant‐based PMBR separately.
Methods
A systematic literature search was performed in MEDLINE, Cochrane Library, and Embase. The Cochrane Collaboration Handbook and Meta‐analysis Of Observational Studies in Epidemiology checklist were followed for data ion. Variability in point estimates attributable to heterogeneity was assessed using I2‐statistic. (Loco)regional breast cancer recurrence rates, distant metastasis rates, and overall breast cancer recurrence rates were pooled in generalized linear mixed models using random effects.
Results
Fifty‐five studies, evaluating 14,217 patients, were included. When comparing immediate versus delayed autologous PMBR, weighted average proportions were: 0.03 (95% confidence interval [CI], 0.02–0.03) versus 0.02 (95% CI, 0.01–0.04), respectively, for local recurrences, 0.02 (95% CI, 0.01–0.03) versus 0.02 (95% CI, 0.01–0.03) for regional recurrences, and 0.04 (95% CI, 0.03–0.06) versus 0.01 (95% CI, 0.00–0.03) for locoregional recurrences. No statistically significant differences in weighted average proportions for local, regional and locoregional recurrence rates were observed between immediate and delayed autologous PMBR. Data did not allow comparing weighted average proportions of distant metastases and total breast cancer recurrences after autologous PMBR, and of all outcome measures after implant‐based PMBR.
Conclusions
Delayed autologous PMBR leads to similar (loco)regional breast cancer recurrence rates compared to immediate autologous PMBR. This study highlights the paucity of strong evidence on breast cancer recurrence after specific types and timings of PMBR.
Lay summery
Oncologic safety of different types and timings of postmastectomy breast reconstruction (PMBR) remains controversial.
Lack of stratified risk assessment in literature makes clinical and shared decision‐making complex.
This meta‐analysis showed that delayed autologous PMBR leads to similar (loco)regional recurrence rates as immediate autologous PMBR. Data did not allow comparing weighted average proportions of distant metastases and to |
| doi_str_mv | 10.1002/cncr.34393 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2695287121</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2709945508</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3933-ddf5154cb310f09cf26a420878757e9f9fc5ee170546071e35c921763649edfb3</originalsourceid><addsrcrecordid>eNp9kc1KHTEUx0NReq-2Gx9ABroRYWw-J5PldahaEAulhe6G3MwJRObjmmS8zE7oC7joE_okRkdddOEqOcnv_DjJH6EDgk8IxvSr6Y0_YZwp9gEtCVYyx4TTHbTEGJe54OzPAu2FcJ1KSQX7iBZMlIorVizR31MPOsTM6N6AzzyY0XtI-0zbmA5c10HjdEx132QNtHqCJtsMIXapDUwcuilbz47UPPQh-tFEN_QPd_9WWZgS1OnoTLq9dbB91nQQ9cPdve51OwUXPqFdq9sAn1_WffT77Nuv6iK__HH-vVpd5iY9jeVNYwUR3KwZwRYrY2mhOcWlLKWQoKyyRgAQiQUvsCTAhFGUyIIVXEFj12wfHc3ejR9uRgix7lww0La6h2EMNS2UoKUklCT0y3_o9TD6NG-iJFaKC4HLRB3PlPFDCB5svfGu036qCa6foqmfoqmfo0nw4YtyXKc_fUNfs0gAmYGta2F6R1VXV9XPWfoIURudQw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2709945508</pqid></control><display><type>article</type><title>Breast cancer recurrence after immediate and delayed postmastectomy breast reconstruction—A systematic review and meta‐analysis</title><source>Wiley Free Content</source><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>Alma/SFX Local Collection</source><creator>Bargon, Claudia A. ; Young‐Afat, Danny A. ; Ikinci, Mehmet ; Braakenburg, Assa ; Rakhorst, Hinne A. ; Mureau, Marc A.M. ; Verkooijen, Helena M. ; Doeksen, Annemiek</creator><creatorcontrib>Bargon, Claudia A. ; Young‐Afat, Danny A. ; Ikinci, Mehmet ; Braakenburg, Assa ; Rakhorst, Hinne A. ; Mureau, Marc A.M. ; Verkooijen, Helena M. ; Doeksen, Annemiek</creatorcontrib><description>Background
Oncological safety of different types and timings of PMBR after breast cancer remains controversial. Lack of stratified risk assessment in literature makes current clinical and shared decision‐making complex. This is the first systematic review and meta‐analysis to evaluate differences in oncological outcomes after immediate versus delayed postmastectomy breast reconstruction (PMBR) for autologous and implant‐based PMBR separately.
Methods
A systematic literature search was performed in MEDLINE, Cochrane Library, and Embase. The Cochrane Collaboration Handbook and Meta‐analysis Of Observational Studies in Epidemiology checklist were followed for data ion. Variability in point estimates attributable to heterogeneity was assessed using I2‐statistic. (Loco)regional breast cancer recurrence rates, distant metastasis rates, and overall breast cancer recurrence rates were pooled in generalized linear mixed models using random effects.
Results
Fifty‐five studies, evaluating 14,217 patients, were included. When comparing immediate versus delayed autologous PMBR, weighted average proportions were: 0.03 (95% confidence interval [CI], 0.02–0.03) versus 0.02 (95% CI, 0.01–0.04), respectively, for local recurrences, 0.02 (95% CI, 0.01–0.03) versus 0.02 (95% CI, 0.01–0.03) for regional recurrences, and 0.04 (95% CI, 0.03–0.06) versus 0.01 (95% CI, 0.00–0.03) for locoregional recurrences. No statistically significant differences in weighted average proportions for local, regional and locoregional recurrence rates were observed between immediate and delayed autologous PMBR. Data did not allow comparing weighted average proportions of distant metastases and total breast cancer recurrences after autologous PMBR, and of all outcome measures after implant‐based PMBR.
Conclusions
Delayed autologous PMBR leads to similar (loco)regional breast cancer recurrence rates compared to immediate autologous PMBR. This study highlights the paucity of strong evidence on breast cancer recurrence after specific types and timings of PMBR.
Lay summery
Oncologic safety of different types and timings of postmastectomy breast reconstruction (PMBR) remains controversial.
Lack of stratified risk assessment in literature makes clinical and shared decision‐making complex.
This meta‐analysis showed that delayed autologous PMBR leads to similar (loco)regional recurrence rates as immediate autologous PMBR. Data did not allow comparing weighted average proportions of distant metastases and total breast cancer recurrence after autologous PMBR, and of all outcome measures after implant‐based PMBR.
Based on current evidence, oncological concerns do not seem a valid reason to withhold patients from certain reconstructive timings or techniques, and patients should equally be offered all reconstructive options they technically qualify for.
Oncologic safety of different types and timings of postmastectomy breast reconstruction (PMBR) remains controversial. This meta‐analysis showed that delayed autologous PMBR leads to similar (loco)regional breast cancer recurrence rates compared to immediate autologous PMBR.</description><identifier>ISSN: 0008-543X</identifier><identifier>ISSN: 1097-0142</identifier><identifier>EISSN: 1097-0142</identifier><identifier>DOI: 10.1002/cncr.34393</identifier><identifier>PMID: 35894936</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>autologous ; Breast cancer ; breast neoplasm ; Breast Neoplasms - pathology ; breast reconstruction ; Confidence intervals ; Decision analysis ; Decision making ; Epidemiology ; Evaluation ; Female ; Heterogeneity ; Humans ; implant ; Mammaplasty - adverse effects ; Mammaplasty - methods ; Mastectomy ; Meta-analysis ; Metastases ; Metastasis ; Neoplasm Recurrence, Local - epidemiology ; Neoplasm Recurrence, Local - surgery ; oncological safety ; Oncology ; Patients ; recurrence ; Risk assessment ; Safety ; Statistical analysis ; Statistical models ; Systematic review ; Transplantation, Autologous</subject><ispartof>Cancer, 2022-10, Vol.128 (19), p.3449-3469</ispartof><rights>2022 The Authors. published by Wiley Periodicals LLC on behalf of American Cancer Society.</rights><rights>2022 The Authors. Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.</rights><rights>2022. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3933-ddf5154cb310f09cf26a420878757e9f9fc5ee170546071e35c921763649edfb3</citedby><cites>FETCH-LOGICAL-c3933-ddf5154cb310f09cf26a420878757e9f9fc5ee170546071e35c921763649edfb3</cites><orcidid>0000-0002-5558-1530 ; 0000-0002-1663-6092 ; 0000-0001-9480-1623 ; 0000-0001-9628-5896 ; 0000-0002-7472-009X ; 0000-0001-6941-7734</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fcncr.34393$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fcncr.34393$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35894936$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bargon, Claudia A.</creatorcontrib><creatorcontrib>Young‐Afat, Danny A.</creatorcontrib><creatorcontrib>Ikinci, Mehmet</creatorcontrib><creatorcontrib>Braakenburg, Assa</creatorcontrib><creatorcontrib>Rakhorst, Hinne A.</creatorcontrib><creatorcontrib>Mureau, Marc A.M.</creatorcontrib><creatorcontrib>Verkooijen, Helena M.</creatorcontrib><creatorcontrib>Doeksen, Annemiek</creatorcontrib><title>Breast cancer recurrence after immediate and delayed postmastectomy breast reconstruction—A systematic review and meta‐analysis</title><title>Cancer</title><addtitle>Cancer</addtitle><description>Background
Oncological safety of different types and timings of PMBR after breast cancer remains controversial. Lack of stratified risk assessment in literature makes current clinical and shared decision‐making complex. This is the first systematic review and meta‐analysis to evaluate differences in oncological outcomes after immediate versus delayed postmastectomy breast reconstruction (PMBR) for autologous and implant‐based PMBR separately.
Methods
A systematic literature search was performed in MEDLINE, Cochrane Library, and Embase. The Cochrane Collaboration Handbook and Meta‐analysis Of Observational Studies in Epidemiology checklist were followed for data ion. Variability in point estimates attributable to heterogeneity was assessed using I2‐statistic. (Loco)regional breast cancer recurrence rates, distant metastasis rates, and overall breast cancer recurrence rates were pooled in generalized linear mixed models using random effects.
Results
Fifty‐five studies, evaluating 14,217 patients, were included. When comparing immediate versus delayed autologous PMBR, weighted average proportions were: 0.03 (95% confidence interval [CI], 0.02–0.03) versus 0.02 (95% CI, 0.01–0.04), respectively, for local recurrences, 0.02 (95% CI, 0.01–0.03) versus 0.02 (95% CI, 0.01–0.03) for regional recurrences, and 0.04 (95% CI, 0.03–0.06) versus 0.01 (95% CI, 0.00–0.03) for locoregional recurrences. No statistically significant differences in weighted average proportions for local, regional and locoregional recurrence rates were observed between immediate and delayed autologous PMBR. Data did not allow comparing weighted average proportions of distant metastases and total breast cancer recurrences after autologous PMBR, and of all outcome measures after implant‐based PMBR.
Conclusions
Delayed autologous PMBR leads to similar (loco)regional breast cancer recurrence rates compared to immediate autologous PMBR. This study highlights the paucity of strong evidence on breast cancer recurrence after specific types and timings of PMBR.
Lay summery
Oncologic safety of different types and timings of postmastectomy breast reconstruction (PMBR) remains controversial.
Lack of stratified risk assessment in literature makes clinical and shared decision‐making complex.
This meta‐analysis showed that delayed autologous PMBR leads to similar (loco)regional recurrence rates as immediate autologous PMBR. Data did not allow comparing weighted average proportions of distant metastases and total breast cancer recurrence after autologous PMBR, and of all outcome measures after implant‐based PMBR.
Based on current evidence, oncological concerns do not seem a valid reason to withhold patients from certain reconstructive timings or techniques, and patients should equally be offered all reconstructive options they technically qualify for.
Oncologic safety of different types and timings of postmastectomy breast reconstruction (PMBR) remains controversial. This meta‐analysis showed that delayed autologous PMBR leads to similar (loco)regional breast cancer recurrence rates compared to immediate autologous PMBR.</description><subject>autologous</subject><subject>Breast cancer</subject><subject>breast neoplasm</subject><subject>Breast Neoplasms - pathology</subject><subject>breast reconstruction</subject><subject>Confidence intervals</subject><subject>Decision analysis</subject><subject>Decision making</subject><subject>Epidemiology</subject><subject>Evaluation</subject><subject>Female</subject><subject>Heterogeneity</subject><subject>Humans</subject><subject>implant</subject><subject>Mammaplasty - adverse effects</subject><subject>Mammaplasty - methods</subject><subject>Mastectomy</subject><subject>Meta-analysis</subject><subject>Metastases</subject><subject>Metastasis</subject><subject>Neoplasm Recurrence, Local - epidemiology</subject><subject>Neoplasm Recurrence, Local - surgery</subject><subject>oncological safety</subject><subject>Oncology</subject><subject>Patients</subject><subject>recurrence</subject><subject>Risk assessment</subject><subject>Safety</subject><subject>Statistical analysis</subject><subject>Statistical models</subject><subject>Systematic review</subject><subject>Transplantation, Autologous</subject><issn>0008-543X</issn><issn>1097-0142</issn><issn>1097-0142</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>EIF</sourceid><recordid>eNp9kc1KHTEUx0NReq-2Gx9ABroRYWw-J5PldahaEAulhe6G3MwJRObjmmS8zE7oC7joE_okRkdddOEqOcnv_DjJH6EDgk8IxvSr6Y0_YZwp9gEtCVYyx4TTHbTEGJe54OzPAu2FcJ1KSQX7iBZMlIorVizR31MPOsTM6N6AzzyY0XtI-0zbmA5c10HjdEx132QNtHqCJtsMIXapDUwcuilbz47UPPQh-tFEN_QPd_9WWZgS1OnoTLq9dbB91nQQ9cPdve51OwUXPqFdq9sAn1_WffT77Nuv6iK__HH-vVpd5iY9jeVNYwUR3KwZwRYrY2mhOcWlLKWQoKyyRgAQiQUvsCTAhFGUyIIVXEFj12wfHc3ejR9uRgix7lww0La6h2EMNS2UoKUklCT0y3_o9TD6NG-iJFaKC4HLRB3PlPFDCB5svfGu036qCa6foqmfoqmfo0nw4YtyXKc_fUNfs0gAmYGta2F6R1VXV9XPWfoIURudQw</recordid><startdate>20221001</startdate><enddate>20221001</enddate><creator>Bargon, Claudia A.</creator><creator>Young‐Afat, Danny A.</creator><creator>Ikinci, Mehmet</creator><creator>Braakenburg, Assa</creator><creator>Rakhorst, Hinne A.</creator><creator>Mureau, Marc A.M.</creator><creator>Verkooijen, Helena M.</creator><creator>Doeksen, Annemiek</creator><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TO</scope><scope>7U7</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-5558-1530</orcidid><orcidid>https://orcid.org/0000-0002-1663-6092</orcidid><orcidid>https://orcid.org/0000-0001-9480-1623</orcidid><orcidid>https://orcid.org/0000-0001-9628-5896</orcidid><orcidid>https://orcid.org/0000-0002-7472-009X</orcidid><orcidid>https://orcid.org/0000-0001-6941-7734</orcidid></search><sort><creationdate>20221001</creationdate><title>Breast cancer recurrence after immediate and delayed postmastectomy breast reconstruction—A systematic review and meta‐analysis</title><author>Bargon, Claudia A. ; Young‐Afat, Danny A. ; Ikinci, Mehmet ; Braakenburg, Assa ; Rakhorst, Hinne A. ; Mureau, Marc A.M. ; Verkooijen, Helena M. ; Doeksen, Annemiek</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3933-ddf5154cb310f09cf26a420878757e9f9fc5ee170546071e35c921763649edfb3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2022</creationdate><topic>autologous</topic><topic>Breast cancer</topic><topic>breast neoplasm</topic><topic>Breast Neoplasms - pathology</topic><topic>breast reconstruction</topic><topic>Confidence intervals</topic><topic>Decision analysis</topic><topic>Decision making</topic><topic>Epidemiology</topic><topic>Evaluation</topic><topic>Female</topic><topic>Heterogeneity</topic><topic>Humans</topic><topic>implant</topic><topic>Mammaplasty - adverse effects</topic><topic>Mammaplasty - methods</topic><topic>Mastectomy</topic><topic>Meta-analysis</topic><topic>Metastases</topic><topic>Metastasis</topic><topic>Neoplasm Recurrence, Local - epidemiology</topic><topic>Neoplasm Recurrence, Local - surgery</topic><topic>oncological safety</topic><topic>Oncology</topic><topic>Patients</topic><topic>recurrence</topic><topic>Risk assessment</topic><topic>Safety</topic><topic>Statistical analysis</topic><topic>Statistical models</topic><topic>Systematic review</topic><topic>Transplantation, Autologous</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bargon, Claudia A.</creatorcontrib><creatorcontrib>Young‐Afat, Danny A.</creatorcontrib><creatorcontrib>Ikinci, Mehmet</creatorcontrib><creatorcontrib>Braakenburg, Assa</creatorcontrib><creatorcontrib>Rakhorst, Hinne A.</creatorcontrib><creatorcontrib>Mureau, Marc A.M.</creatorcontrib><creatorcontrib>Verkooijen, Helena M.</creatorcontrib><creatorcontrib>Doeksen, Annemiek</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bargon, Claudia A.</au><au>Young‐Afat, Danny A.</au><au>Ikinci, Mehmet</au><au>Braakenburg, Assa</au><au>Rakhorst, Hinne A.</au><au>Mureau, Marc A.M.</au><au>Verkooijen, Helena M.</au><au>Doeksen, Annemiek</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Breast cancer recurrence after immediate and delayed postmastectomy breast reconstruction—A systematic review and meta‐analysis</atitle><jtitle>Cancer</jtitle><addtitle>Cancer</addtitle><date>2022-10-01</date><risdate>2022</risdate><volume>128</volume><issue>19</issue><spage>3449</spage><epage>3469</epage><pages>3449-3469</pages><issn>0008-543X</issn><issn>1097-0142</issn><eissn>1097-0142</eissn><abstract>Background
Oncological safety of different types and timings of PMBR after breast cancer remains controversial. Lack of stratified risk assessment in literature makes current clinical and shared decision‐making complex. This is the first systematic review and meta‐analysis to evaluate differences in oncological outcomes after immediate versus delayed postmastectomy breast reconstruction (PMBR) for autologous and implant‐based PMBR separately.
Methods
A systematic literature search was performed in MEDLINE, Cochrane Library, and Embase. The Cochrane Collaboration Handbook and Meta‐analysis Of Observational Studies in Epidemiology checklist were followed for data ion. Variability in point estimates attributable to heterogeneity was assessed using I2‐statistic. (Loco)regional breast cancer recurrence rates, distant metastasis rates, and overall breast cancer recurrence rates were pooled in generalized linear mixed models using random effects.
Results
Fifty‐five studies, evaluating 14,217 patients, were included. When comparing immediate versus delayed autologous PMBR, weighted average proportions were: 0.03 (95% confidence interval [CI], 0.02–0.03) versus 0.02 (95% CI, 0.01–0.04), respectively, for local recurrences, 0.02 (95% CI, 0.01–0.03) versus 0.02 (95% CI, 0.01–0.03) for regional recurrences, and 0.04 (95% CI, 0.03–0.06) versus 0.01 (95% CI, 0.00–0.03) for locoregional recurrences. No statistically significant differences in weighted average proportions for local, regional and locoregional recurrence rates were observed between immediate and delayed autologous PMBR. Data did not allow comparing weighted average proportions of distant metastases and total breast cancer recurrences after autologous PMBR, and of all outcome measures after implant‐based PMBR.
Conclusions
Delayed autologous PMBR leads to similar (loco)regional breast cancer recurrence rates compared to immediate autologous PMBR. This study highlights the paucity of strong evidence on breast cancer recurrence after specific types and timings of PMBR.
Lay summery
Oncologic safety of different types and timings of postmastectomy breast reconstruction (PMBR) remains controversial.
Lack of stratified risk assessment in literature makes clinical and shared decision‐making complex.
This meta‐analysis showed that delayed autologous PMBR leads to similar (loco)regional recurrence rates as immediate autologous PMBR. Data did not allow comparing weighted average proportions of distant metastases and total breast cancer recurrence after autologous PMBR, and of all outcome measures after implant‐based PMBR.
Based on current evidence, oncological concerns do not seem a valid reason to withhold patients from certain reconstructive timings or techniques, and patients should equally be offered all reconstructive options they technically qualify for.
Oncologic safety of different types and timings of postmastectomy breast reconstruction (PMBR) remains controversial. This meta‐analysis showed that delayed autologous PMBR leads to similar (loco)regional breast cancer recurrence rates compared to immediate autologous PMBR.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>35894936</pmid><doi>10.1002/cncr.34393</doi><tpages>21</tpages><orcidid>https://orcid.org/0000-0002-5558-1530</orcidid><orcidid>https://orcid.org/0000-0002-1663-6092</orcidid><orcidid>https://orcid.org/0000-0001-9480-1623</orcidid><orcidid>https://orcid.org/0000-0001-9628-5896</orcidid><orcidid>https://orcid.org/0000-0002-7472-009X</orcidid><orcidid>https://orcid.org/0000-0001-6941-7734</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | Cancer, 2022-10, Vol.128 (19), p.3449-3469 |
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| source | Wiley Free Content; MEDLINE; Wiley Online Library Journals Frontfile Complete; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | autologous Breast cancer breast neoplasm Breast Neoplasms - pathology breast reconstruction Confidence intervals Decision analysis Decision making Epidemiology Evaluation Female Heterogeneity Humans implant Mammaplasty - adverse effects Mammaplasty - methods Mastectomy Meta-analysis Metastases Metastasis Neoplasm Recurrence, Local - epidemiology Neoplasm Recurrence, Local - surgery oncological safety Oncology Patients recurrence Risk assessment Safety Statistical analysis Statistical models Systematic review Transplantation, Autologous |
| title | Breast cancer recurrence after immediate and delayed postmastectomy breast reconstruction—A systematic review and meta‐analysis |
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