Breast Cancer Local Recurrence in Patients with and without Post-Mastectomy Immediate Breast Reconstruction: Systematic Review & Meta-Analysis Protocol

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This systematic review protocol outlines a plan to compare local recurrence rates between patients undergoing mastectomy with immediate breast reconstruction versus mastectomy alone for early-stage breast cancer.

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This paper describes the protocol for a systematic review and meta-analysis assessing breast cancer local recurrence in patients who receive post-mastectomy immediate breast reconstruction versus those who do not, using study-level data to estimate comparative recurrence outcomes. The work lays out the planned methods for searching, selecting, extracting, and synthesizing eligible studies, along with the approach for quantifying and combining effect estimates across included reports. A key limitation acknowledged for protocol papers is that no results are reported yet; the conclusions depend entirely on the quality and availability of the studies ultimately included in the review. The paper does not explicitly discuss endometriosis or adenomyosis; it was included in the corpus via a keyword match in the upstream search index.

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Abstract

Abstract Introduction: Today mastectomy and breast reconstruction are often coupled for women with breast cancer, where mastectomy has the chance to remove the tumour and reconstruction improves the aesthetic appearance. While rates of post-mastectomy immediate breast reconstruction (IBR) are on the rise, there remains fears of local recurrence (LR).1,2 Purpose: This systematic review aims to compare long-term LR rates in a group of patients with mastectomy and IBR (Mast + IBR) to a group of patients with mastectomy without IBR (Mast – IBR). Methods: The online databases Medline, Embase, and Web of Science will be searched for relevant articles. Articles published between January 2000 to December 2020 that report LR rates for groups patients who underwent mastectomy for stage I or II breast cancer with or without IBR with stage will be included. The risk of bias will be assessed using the Johanna Briggs Institute scale for observational studies. A fixed-effects meta-regression model will calculate the pooled odds ratio with a 95% confidence interval, adjusted for age and follow-up time. Implications: Moreover, this review will synthesis the literature surrounding the study factors, patient factors, reconstructive factors, and outcome factors associated with LR. Finally, the findings will be used to develop clinical recommendations for breast cancer reconstruction. Ethics and dissemination: Ethics approval is not required. The systematic review will be submitted for publication in a peer-reviewed journal.
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