Immediate, delayed breast reconstruction equally safe

Immediate and delayed autologous breast reconstruction yield similar rates of complications in the context of postmastectomy radiation therapy (PMRT), a new meta-analysis reports.

“Given the patient benefits incurred by an immediate reconstruction algorithm, immediate autologous breast reconstruction should be considered as a viable treatment option in patients requiring PMRT,” the researchers said.

Searching through the databases of PubMed, Embase, Medline, The Cochrane Library, Google Scholar, Scopus, and Web of Science, the researchers identified 44 studies eligible for quantitative analysis. Cumulatively, 3,473 total patients were included, of whom 1,927 underwent immediate and 1,546 delayed reconstruction.

Outcomes were early (flap loss, fat necrosis, seroma, etc) and late (fibrosis, severe asymmetry, hyperpigmentation, etc) complications.

In general, complications occurred at comparable rates between the immediate and delayed reconstruction groups. Fat necrosis, for example, was observed in 14.91 percent and 8.12 percent of patients undergoing the respective procedures (p=0.076).

The same was true for flap loss (immediate vs delayed: 0.99 percent vs 1.80 percent; p=0.295), haematoma (1.91 percent vs 1.14 percent; p=0.247), and thrombosis (1.51 percent vs 3.36 percent; p=0.150).

Notably, infections occurred in 11.66 percent and 4.68 percent of patients receiving immediate and delayed reconstruction, respectively. However, the large mean difference still failed to reach statistical significance (p=0.155).

The only exception was seroma, which occurred at a significantly lower frequency in women opting for immediate reconstruction (2.69 percent vs 10.57 percent; p=0.042).