Abstract PS13-15: Impact of neoadjuvant chemotherapy on breast reconstruction - systematic review and meta-analysis

Abstract

Abstract BackgroundImpact of neoadjuvant chemotherapy (NACT) on breast reconstruction outcomes remain unclear. We did a systematic review and meta-analysis to assess the effect of NACT on post-operative complications and delay to adjuvant therapy among women undergoing immediate breast reconstruction. MethodsIn this systematic review and meta-analysis, we searched medical databases from inception of this technique to May 2, 2020 to identify articles that assessed the impact of NACT on separate techniques of immediate breast reconstruction. Studies reporting on at least one of our pre-defined major post-operative complications were included. Study authors were contacted for individual patient-level data which was not available. Study quality and risk of bias are reported through NOS Scores and GRADE table. PROSPERO registration CRD42020183761. FindingsOf 477 identified articles, 17 studies (3249 patients) were eligible for inclusion. NACT did not increase the risk of overall complications after immediate breast reconstructions RR: 0.91(95% CI 0.74 to 1.11, p = 0.34). There was no large increase in flap losses (total and partial) in patients receiving NACT compared to control group (RR:1.23, 95% CI 0.70 to 2.18, p = 0.47; I2 = 0%). There was however, some evidence of increased risk of implant/expander loss after NACT treatment (RR:1.50, 95% CI 1.03 to 2.20, p = 0.04; I2 = 34%). NACT treatment was not associated with increase in haematomas, seromas or wound complications or significant delay to adjuvant therapy access; RR:1.59, 95% CI 0.66 to 3.87, p = 0.30 InterpretationImmediate breast reconstruction after treatment with NACT remains a safe procedure. Careful patient selection may play a bigger role when planning implant-based reconstructions after NACT. FundingNone. Citation Format: Jajini Susan Varghese, Shireen Gohari, Michael Shawky, Faith Hyun, Laura Johnson, Peter Schmid. Impact of neoadjuvant chemotherapy on breast reconstruction - systematic review and meta-analysis [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS13-15.