ADM-assisted prepectoral breast reconstruction is not associated with high complication rate as before: a Meta-analysis

Xie, Jiaheng; Wang, Ming; Cao, Yuan; Zhu, Zhechen; Ruan, Shujie; Ou, Mengmeng; Yu, Pan; Shi, Jingping

doi:10.1080/2000656x.2021.1981351

Cited by 15 publications

(10 citation statements)

References 53 publications

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“…At least four other recent reviews have used similar methodology. [61][62][63][64] Murphy et al also recently reviewed ADM versus no-ADM reconstructions, but did not specifically stratify by plane of reconstruction or Fig. 3.…”

Section: Discussionmentioning

confidence: 99%

Prepectoral versus Subpectoral Breast Reconstruction after Nipple-sparing Mastectomy: A Systematic Review and Meta-Analysis

Nolan,

Farajzadeh,

Bekisz

et al. 2024

Plastic and Reconstructive Surgery - Global Open

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Background: Implant-based breast reconstruction after nipple-sparing mastectomy (NSM) presents unique benefits and challenges. The literature has compared outcomes among total submuscular (TSM), dual-plane (DP), and prepectoral (PP) planes; however, a dedicated meta-analysis relevant to NSM is lacking. Methods: We conducted a systematic review of studies on immediate breast reconstruction after NSM using TSM, DP, or PP prosthesis placement in PubMed, Embase, and Cochrane databases. In total, 1317 unique articles were identified, of which 49 were included in the systematic review and six met inclusion criteria for meta-analysis. Pooled descriptive outcomes were analyzed for each cohort for all 49 studies. Fixed-effects meta-analytic methods were used to compare PP with subpectoral (TSM and DP) reconstructions. Results: A total of 1432 TSM, 1546 DP, and 1668 PP reconstructions were identified for descriptive analysis. Demographics were similar between cohorts. Pooled descriptive outcomes demonstrated overall similar rates of reconstructive failure (3.3%–5.1%) as well as capsular contracture (0%–3.9%) among cohorts. Fixed-effects meta-analysis of six comparative studies demonstrated a significantly lower rate of mastectomy flap necrosis in the PP cohort compared with the subpectoral cohort (relative risk 0.24, 95% confidence interval [0.08–0.74]). All other consistently reported outcomes, including, hematoma, seroma, infection, mastectomy flap necrosis, nipple -areola complex necrosis, and explantation were comparable. Conclusions: A systematic review of the literature and meta-analysis demonstrated the safety of immediate prepectoral breast reconstruction after NSM, compared with submuscular techniques. Submuscular reconstruction had a higher risk of mastectomy flap necrosis, though potentially influenced by selection bias.

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Section: Discussionmentioning

confidence: 99%

Prepectoral versus Subpectoral Breast Reconstruction after Nipple-sparing Mastectomy: A Systematic Review and Meta-Analysis

Nolan,

Farajzadeh,

Bekisz

et al. 2024

Plastic and Reconstructive Surgery - Global Open

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“…Immediate implant and autologous breast reconstruction can be safely performed with a similar or higher survival outcome compared to mastectomy only patients ( 18 ). Due to the safety of IBR and the advance of materials and surgical technique, some novel breast reconstruction options are invented and performed, such as pre-pectoral implant breast reconstruction ( 21 ). As the field of breast reconstruction continues to evolve, other modalities aimed to optimize the esthetic reconstructed breasts are on the horizon and will become a reality in the near future.…”

Section: Discussionmentioning

confidence: 99%

A Single-Center Retrospective Analysis of Local and Distant Relapse of Breast Cancer Following Immediate Breast Reconstruction According to Molecular Subtypes

et al. 2022

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PurposeConcerns have been raised about the oncologic safety of immediate breast reconstruction (IBR) following mastectomy for breast cancer. This study aimed to evaluate locoregional recurrence (LRR) and distant metastasis (DM) of breast cancer according to its molecular subtype in patients who underwent mastectomy alone or IBR after mastectomy.MethodsIn this retrospective cohort study, consecutive breast cancer patients treated by the single senior surgeon (XZ) between February 2010 and December 2014 were eligible. In total, 389 consecutive patients were included; 295 patients underwent mastectomy alone and 94 patients underwent mastectomy with IBR. Data were retrospectively collected and analyzed for LRR and DM stratified by molecular subtypes.ResultsWith a median follow-up of 73 and 87.5 months, 1.69% of patients in the mastectomy alone group developed LRR compared to 0% in the reconstruction group (p = 0.342) and the total incidence of DMs was 11.52% in patients who received mastectomy alone and 7.44% in patients who received postmastectomy IBR (p = 0.262), respectively. The cumulative incidence of LRR was 2.1% vs. 0% for luminal A, 0% vs. 0% for luminal B, 0% vs. 0% for human epidermal growth factor receptor 2 (HER2)-enriched, and 4.5% vs. 0% for triple-negative in the mastectomy alone group compared to the postmastectomy IBR group. The cumulative incidence of DM was 15.5% vs. 5.7% for luminal A, 10% vs. 8.7% for luminal B, 17.3% vs. 0% for HER2-enriched, and 6.8% vs. 7.1% for triple-negative in the mastectomy alone group compared to the postmastectomy IBR group. On multivariable Cox regression analysis, lymph node metastasis was associated with an increased risk of DM in the mastectomy alone group (p = 0.03) and neoadjuvant chemotherapy was associated with an increased risk of DM in the postmastectomy IBR group (p = 0.021).ConclusionThis study suggests that IBR does not have a negative impact on the LRR and DM of breast cancer according to molecular subtypes.

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“…WHO released a report in early 2021, indicating that breast cancer has surpassed lung cancer to become the most common tumor in the world. 1 Surgical resection of tumors is a conventional treatment for breast cancer. Failure in breast preservation will cause physical deficiency, psychological inferiority, and lower social integration and life happiness of patients.…”

Section: Introductionmentioning

confidence: 99%

Advances in Prepectoral Breast Reconstruction

Xie¹,

Yan²,

Zhu³

et al. 2023

TCRM

Self Cite

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Breast reconstruction can be divided into prepectoral breast reconstruction (PPBR) and subpectoral breast reconstruction (SPBR) according to the implant plane. The original prepectoral breast reconstruction was abandoned for a long time due to the frequent and severe complications. Now, advances in materials technology and improved methods of mastectomy have made safe prepectoral breast reconstruction possible. Moreover, a number of studies have gradually demonstrated the advantages of prepectoral breast reconstruction. As prepectoral breast reconstruction becomes more and more attractive, it is time to review the current advances in prepectoral breast reconstruction.

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ADM-assisted prepectoral breast reconstruction is not associated with high complication rate as before: a Meta-analysis

Cited by 15 publications

References 53 publications

Prepectoral versus Subpectoral Breast Reconstruction after Nipple-sparing Mastectomy: A Systematic Review and Meta-Analysis

Prepectoral versus Subpectoral Breast Reconstruction after Nipple-sparing Mastectomy: A Systematic Review and Meta-Analysis

A Single-Center Retrospective Analysis of Local and Distant Relapse of Breast Cancer Following Immediate Breast Reconstruction According to Molecular Subtypes

Advances in Prepectoral Breast Reconstruction

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