Comparative complications of prepectoral versus subpectoral breast reconstruction in patients with breast cancer: a meta-analysis

This meta-analysis aims to evaluate the complications associated with prepectoral breast reconstruction (PBR) compared to subpectoral breast reconstruction (SBR) in patients diagnosed with breast cancer. A comprehensive search was performed in four databases, including Medline, Embase, Web of Scienc...

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Bibliographic Details
Published in:Frontiers in oncology 2024-08, Vol.14, p.1439293
Main Authors: Wu, Yongxiao, Yu, Lizhi, Huang, Miaoyan, Huang, Yanping, Li, Chunyan, Liang, Yiwen, Liang, Weiming, Qin, Tian
Format: Article
Language:English
Subjects:
breast cancer
complication
meta-analysis
Oncology
prepectoral
reconstruction
subpectoral
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Summary:This meta-analysis aims to evaluate the complications associated with prepectoral breast reconstruction (PBR) compared to subpectoral breast reconstruction (SBR) in patients diagnosed with breast cancer. A comprehensive search was performed in four databases, including Medline, Embase, Web of Science and CENTRAL, to collect literature published up until December 31, 2024. In addition, we conducted a thorough manual examination of the bibliographies of the identified papers, as well as pertinent reviews and meta-analyses. We conducted a search on three clinical trial registries, namely ClinicalTrials.gov, Controlled-trials.com, and Umin.ac.jp/ctr/index.htm. Meta-analyses were conducted on total complications, hematoma, infection, wound healing issues, necrosis, capsular contracture, rippling, animation deformity, and reoperation. A total of 40 studies were included in the meta-analysis. Compared with SBR, PBR significantly reduced the incidence of animated malformations (OR=0.37, 95% CI: 0.19 to 0.70, P=0.003, I ²=12%), but increased the incidence of ripples (OR=2.39, 95% CI: 1.53 to 3.72, P=0.0001, I ²=10%) and seroma (OR=1.55, 95% CI: 1.02 to 2.35, P=0.04, increasing I ²=70%). Our findings indicate that PBR and SBR have comparable safety profiles, with similar total complication rates. Specifically, PBR is more likely to cause rippling and seroma, whereas SBR is more prone to causing animation deformity. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024565837, identifier CRD42024565837.
ISSN:2234-943X
2234-943X
DOI:10.3389/fonc.2024.1439293