Predictors of Complications after Breast Reconstruction Surgery: A Systematic Review and Meta-analysis

Abstract

Background: Breast reconstruction (BR) is a unique surgical procedure that provides patients undergoing mastectomy with significant psychosocial and aesthetic benefits and has also become a crucial part of the treatment pathway for women with breast cancer. Due to methodological inadequacies and the absence of substantial risk factor analysis, no conclusion can be drawn about the correlation between risk variables and post-surgical complications in BR surgery. We aim to identify the potential risk factors associated with postoperative complications. Methods: We queried MEDLINE and Cochrane CENTRAL from their inception to March 2022, for published randomized controlled trials and observational studies that assessed complications post-reconstruction procedure in breast cancer patients following mastectomy or evaluated at least one of the following outcomes of major or reoperative complications. The results from the studies were presented as odds ratios with 95% confidence intervals and were pooled using a randomeffects model. Results: Our pooled analysis demonstrated a significant correlation with BR postoperative complications and risk factors such as diabetes, hypertension, and obesity. Diabetes and the development of seroma were found to have a significant relationship. Risk variables such as age, radiotherapy, COPD, and smoking had no significant connection with 0-to-30-day readmission and 30-to-90-day readmission. Conclusion:This meta-analysis shows that risk factors like age, smoking history, high blood pressure, and body mass index (BMI) have a big effect on complications after BR, and patients with risk factors have a high rate of developing infection.

In hospital outcomes of autologous and implant‐based breast reconstruction in patients with diabetes mellitus: A population‐based study of 2015–2020 national inpatient sample

“…In contrast, ABR, though chosen less frequently, is considered the gold standard for appropriate candidates. It replicates the natural look and feel of a breast, provides long‐lasting outcomes, is less prone to infections and complications associated with foreign materials, and offers superior psychosocial benefits 5 …”

“…It replicates the natural look and feel of a breast, provides longlasting outcomes, is less prone to infections and complications associated with foreign materials, and offers superior psychosocial benefits. 5 However, each method comes with its own sets of potential complications. ABR carries a higher risk of skin necrosis, excessive scarring, and wound dehiscence, while IBR is more vulnerable to issues, such as infections, seromas, capsular contractures, and hematomas.…”

In hospital outcomes of autologous and implant‐based breast reconstruction in patients with chronic obstructive pulmonary disease

“…It more closely replicates the look and feel of a natural breast, provides lasting durability, and is less prone to infections and complications associated with foreign bodies. 6 Each method has its unique set of potential complications: ABR may lead to issues, such as skin necrosis, wound dehiscence, and excessive scarring, whereas IBR carries risks of infections, seromas, capsular contractures, and hemorrhage/hematomas. 7 Although breast reconstruction is a widely accepted practice, it is still an elective procedure.…”

“…On the other hand, ABR, though less commonly selected, is considered the gold standard for appropriate candidates. It more closely replicates the look and feel of a natural breast, provides lasting durability, and is less prone to infections and complications associated with foreign bodies 6 . Each method has its unique set of potential complications: ABR may lead to issues, such as skin necrosis, wound dehiscence, and excessive scarring, whereas IBR carries risks of infections, seromas, capsular contractures, and hemorrhage/hematomas 7 .…”

What are the most effective exercise, physical activity and dietary interventions to improve body composition in women diagnosed with or at high‐risk of breast cancer? A systematic review and network meta‐analysis

“…Female breast cancer is the most commonly diagnosed cancer worldwide with ~2.3 million new cases and ~700,000 deaths in 2020. 1 Obesity has been recognized as a modifiable risk factor in the development 2 and recurrence of breast cancer 3 and is associated with increased surgical complications during treatment, [4][5][6][7][8] worse adverse cancer-related outcomes, 9 and breast cancer-specific survival. 10 Specifically, women with breast cancer who are overweight or obese during treatment experience ~20%-30% increased risk of cancer-related and all-cause mortality.…”