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

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Listed:
  • Junlong Song
  • Xiang Zhang
  • Qiang Liu
  • Jianheng Peng
  • Xinjie Liang
  • Yuanyuan Shen
  • Hongtao Liu
  • Hongyuan Li

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.

Suggested Citation

  • Junlong Song & Xiang Zhang & Qiang Liu & Jianheng Peng & Xinjie Liang & Yuanyuan Shen & Hongtao Liu & Hongyuan Li, 2014. "Impact of Neoadjuvant Chemotherapy on Immediate Breast Reconstruction: A Meta-Analysis," PLOS ONE, Public Library of Science, vol. 9(5), pages 1-9, May.
    • Handle: RePEc:plo:pone00:0098225
    DOI: 10.1371/journal.pone.0098225
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