Impact of Neoadjuvant Chemotherapy on Immediate Breast Reconstruction: A Meta-Analysis

Junlong Song, Xiang Zhang, Qiang Liu, Jianheng Peng, Xinjie Liang, Yuanyuan Shen, Hongtao Liu and Hongyuan Li

PLOS ONE, 2014, vol. 9, issue 5, 1-9

Abstract: Objective: The objective of this study was to perform a meta-analysis of published studies for evaluating the impact of neoadjuvant chemotherapy (NAC) on immediate breast reconstruction. Methods: We searched medical databases to identify appropriate studies that assessed the impact of NAC on immediate breast reconstruction from the inception of this technique through April 2013. We then performed a meta-analysis of these studies. Results: Our searches identified 11 studies among 1,840 citations. In the meta-analysis, NAC did not increase the overall rate of complications after immediate breast reconstruction (odds ratio [OR] = 0.59; 95% confidence interval[CI] = 0.38–0.91). The complication rate was also unaffected by NAC when we considered infections (OR = 0.82; 95% CI = 0.46–1.45), hematomas (OR = 1.35; 95% CI = 0.57–3.21), and seromas (OR = 0.77; 95% CI = 0.23–2.55). Additionally, expander or implant loss did not significantly increase in patients after NAC (OR = 1.59; 95% CI = 0.91–2.79). Only 2 studies (202 procedures) had reported total autologous flap loss, and they were included in our analysis; both studies found no association between NAC and total flap loss. Conclusion: Our analysis suggests that NAC does not increase the complication rate after immediate breast reconstruction. For appropriately selected patients, immediate breast reconstruction following NAC is a safe procedure. The best way to study this issue in the future is to conduct a multicenter prospective study with a longer follow-up period and more clearly defined parameters.

Date: 2014
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0098225

DOI: 10.1371/journal.pone.0098225

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