Mattia Alexzandra, Alomari Mohammad, Hyjazie Taliah, Devisetti Nitya, Shen Yizhuo, Haykal Siba
From the Division of Plastic and Reconstructive Surgery, Department of Surgery, Yale School of Medicine, New Haven, CT.
Department of Surgery, Mayo Clinic, Jacksonville, FL.
Plast Reconstr Surg Glob Open. 2025 Jun 2;13(6):e6810. doi: 10.1097/GOX.0000000000006810. eCollection 2025 Jun.
Breast reconstruction in de novo metastatic breast cancer (dnMBC) patients is a viable option. There remains no consensus on recommendations. We summarize postreconstruction clinical outcomes in dnMBC patients to identify surgical candidates.
A systematic review was conducted across PubMed/MEDLINE, Scopus, and Web of Science from January 1, 1990, to November 1, 2024. The study methods were in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data on patient demographics, disease characteristics, oncological treatment, surgical details, and clinical outcomes were collected.
A total of 7 studies (2635 breast cancer survivors) were identified. The average (SD) age was 47.5 (2.35) years, and most participants were White (n = 2080, 79.3%). Across studies, 39.0% (n = 761) of patients underwent implant-based reconstruction, 38.8% (n = 757) autologous reconstruction, 5.99% (n = 117) combined reconstruction, and 16.4% (n = 320) were not specified. Most cancers were invasive ductal carcinoma (81.3%) with estrogen-positive (73.1%) or progesterone-positive (48.4%) receptors and human epidermal growth factor receptor 2-positive (33.7%) status. Primary tumors most often metastasized to bone (44.4%) or lymph nodes (38.5%). Overall survival and breast cancer-specific survival rates were prolonged among reconstructed patients without increased predilection for complications or delay in tumor treatment.
Reconstruction in dnMBC patients is an appropriate option, especially among younger patients with oligometastatic disease. Future studies are encouraged to investigate the impact on well-being and prolonged survival rates, which primarily seem to be limited to those with low disease burden and hormone receptor-positive tumor subtypes.
初诊转移性乳腺癌（dnMBC）患者的乳房重建是一种可行的选择。目前对于相关建议尚无共识。我们总结dnMBC患者乳房重建后的临床结果，以确定手术候选者。
于1990年1月1日至2024年11月1日在PubMed/MEDLINE、Scopus和Web of Science数据库中进行系统综述。研究方法符合系统评价和Meta分析的首选报告项目指南。收集患者人口统计学、疾病特征、肿瘤治疗、手术细节和临床结果的数据。
共纳入7项研究（2635例乳腺癌幸存者）。平均（标准差）年龄为47.5（2.35）岁，大多数参与者为白人（n = 2080，79.3%）。在各项研究中，39.0%（n = 761）的患者接受了植入物乳房重建，38.8%（n = 757）接受了自体乳房重建，5.99%（n = 117）接受了联合重建，16.4%（n = 320）未明确说明。大多数癌症为浸润性导管癌（81.3%），雌激素受体阳性（73.1%）或孕激素受体阳性（48.4%），人表皮生长因子受体2阳性（33.7%）。原发性肿瘤最常转移至骨（44.4%）或淋巴结（38.5%）。重建患者的总生存率和乳腺癌特异性生存率延长，且并发症发生率未增加，肿瘤治疗也未延迟。
dnMBC患者的乳房重建是一种合适的选择，尤其是在患有寡转移疾病的年轻患者中。鼓励未来的研究调查其对生活质量和延长生存率的影响，这似乎主要限于疾病负担低和激素受体阳性肿瘤亚型的患者。
