Local breast cancer recurrence after mastectomy and immediate breast reconstruction for invasive cancer: a meta-analysis.
BACKGROUND
The main priorities in the surgical treatment of patients with breast cancer are to achieve cure, local control and prevent recurrence. It is increasingly important to address quality of life and self-image with women undergoing surgical intervention for breast cancer. There is a lack of consensus as to the oncologic safety of immediate breast reconstruction (IBR). The purpose of this paper is to systematically review the literature and compare the frequency of recurrence in patients with and without IBR following mastectomy for breast cancer.


METHODS
Two independent investigators searched PubMed, Embase, and the Cochrane database using predefined search terms. After application of inclusion and exclusion criteria, 10 articles remained. Each article was assessed for quality. Relevant data was collected including recurrence rates, cancer stage, type of mastectomy and reconstruction, adjuvant treatments, and duration of follow-up.


RESULTS
Inter-rater reliability was good at 74% (95% CI: 0, 93%). There was no evidence of study heterogeneity (p for Q-statistic=0.34 and I(2)=12%). The OR ratio for recurrence of breast cancer for mastectomy with IBR as compared to mastectomy alone was 0.98 (95% CI: 0.62, 1.54).


CONCLUSIONS
This meta-analysis demonstrated no evidence for increased frequency of local breast cancer recurrence with IBR compared with mastectomy alone.
Department of Surgery, McMaster University, 237 Barton Street East, Room 604 North, Hamilton, ON L8L 2X2, Canada.
M
M
Gieni
R
R
Avram
L
L
Dickson
F
F
Farrokhyar
P
P
Lovrics
S
S
Faidi
N
N
Sne
D019928:Breast Implantation / Q000706:statistics & numerical data*; D001943:Breast Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000706:statistics & numerical data*; D008408:Mastectomy; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology / Q000473:pathology / Q000517:prevention & control*; D011237:Predictive Value of Tests; D011788:Quality of Life; D015203:Reproducibility of Results; D013524:Surgical Flaps; D016019:Survival Analysis; D016387:Women's Health