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Looking beyond the prepectoral breast reconstruction experience: a systematic literature review on associated oncological safety and cancer recurrence incidence

Abstract

Background

Prepectoral implant-based breast reconstruction has gained popularity in the last years, thanks to the development of accurate and tissue-sparing mastectomies together with the introduction of implant-covering devices as synthetic meshes and acellular dermal matrixes. Along with its diffusion, legitimate doubts on prepectoral reconstruction’s feasibility and oncological safety started raising. To date, there are no available data concerning oncologic outcomes following mastectomy and prepectoral breast reconstruction.

Methods

Electronic search in PubMed, Cochrane Library, and Web of Sciences databases was performed with no language restrictions. First articles’ identification was obtained through title and abstract descriptions and by full text visualization subsequently. Inclusion criterion was the report of outcomes assessment for oncological safety; thus cancer recurrence and incidence of systemic metastasis were recorded. Retrieved citations were screened by two reviewers, and inconsistencies were resolved by a third reviewer.

Results

Nine articles met the inclusion criteria and were included in the current review. Four studies presented control groups with submuscular reconstructions, and no statistical differences in terms of local or systemic recurrences were evidenced.

Conclusions

Taking into account the scarce number of articles at disposal, oncological safety of prepectoral breast reconstruction appears equal to the submuscular procedure. Further studies are needed to validate these data.

Level of evidence: Not gradable.

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Fig. 1

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Correspondence to Juste Kaciulyte.

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This review article does not contain any studies involving human participants or animals performed by any of the authors. For this kind of study no ethical approval is required.

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Conflict of interest

Dr. Casella has been contracted (March 2018) for attending events and workshop as a guest speaker, on an “ad hoc” basis contractor or freelance consultant agreement with pfm medical, TILOOP Bra manufacturing company. Juste Kaciulyte, Luca Resca, Federico Lo Torto, Gianluigi Luridiana, Valeria Restaino, Giuseppe Diluiso, Alessandro Neri, Diego Ribuffo, Marco Marcasciano authors declare that they have no conflict of interest.

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Casella, D., Kaciulyte, J., Resca, L. et al. Looking beyond the prepectoral breast reconstruction experience: a systematic literature review on associated oncological safety and cancer recurrence incidence. Eur J Plast Surg (2021). https://doi.org/10.1007/s00238-021-01868-4

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Keywords

  • Prepectoral breast reconstruction
  • Breast cancer recurrence
  • Oncological safety
  • Systematic review