The impact of post-operative wound complications on oncological outcomes following immediate breast reconstruction for breast cancer: A Meta-Analysis

ABSTRACT Introduction The association between immediate breast reconstruction (IBR) related wound complications and breast cancer recurrence (BCR) remains uncertain. This study aimed to investigate the oncological outcomes in patients with wound complications following mastectomy and IBR. Methods A comprehensive search was undertaken for all studies describing complications in breast cancer patients following IBR. Studies were included if they reported on complications and investigated their relationship with BCR. Meta-analysis was performed using a random-effects model with data presented as odds ratio (OR) and 95% confidence intervals. Results A total of 1418 patients from five studies were included in the final analysis. The mean age of patients included was 47.2 years. A total of 382 (26.9%) patients had postoperative complications following majority implant based IBR (929/1418). 158 recurrences (11.1%) which included 63 locoregional and 106 distant recurrences was noted at mean follow up of 66 months. Although there was an increase in recurrence rates in the complication group (n = 66/382, 17.3% versus n = 92/1036, 8.9%), there was no significant association between complications and BCR (17.3% vs 8.9%, p = 0.18) or mortality (3.6% vs 2.3%, p = 0.15). Time to adjuvant therapy was significantly increased in patients with complications (Mean difference (MD): 8.69 days [1.18-16.21], p: 0.02, I2: 0.02). Conclusion This meta-analysis demonstrated a higher incidence of wound complications following IBR and a statistically significant increased time to adjuvant therapy. However, this did not translate into adverse oncological outcomes in breast cancer patients undergoing IBR.