Study on the Impact of Post-Mastectomy Radiotherapy on Immediate Breast Reconstruction and Complications: A Meta-Analysis

Background and objective: Immediate breast reconstruction not only reduces the number of surgeries for patients after mastectomy but also decreases psychological and physical trauma, making it increasingly popular. However, there is currently no consensus on the integration of post-mastectomy radiotherapy (PMRT) with reconstruction techniques. This review evaluates the impact of PMRT on complications following immediate breast reconstruction, providing guidance for clinical treatment decisions. Methods: PubMed, Web of Science, Embase, and other databases were searched for studies published in the past 15 years on outcomes of implant-based breast reconstruction in the context of radiotherapy to identify articles for analysis. RevMan 5.4 software was used to analyze the risks of seroma, infection, wound dehiscence, flap necrosis, implant exposure, capsule contracture, and reconstruction failure. Results: A total of 11 relevant studies were included, comprising 6323 cases of immediate breast reconstruction. It was found that breasts receiving postoperative irradiation had a significantly increased risk of complications, with statistically significant differences in seroma (P = 0.004), infection (P < 0.00001), wound dehiscence (P = 0.04), implant exposure (P < 0.00001), capsule contracture (P < 0.00001), and reconstruction failure (P < 0.00001). There was no statistically significant difference in flap necrosis (P = 0.88). Conclusion: The results indicate that postoperative radiotherapy significantly increases the risk of complications for patients undergoing immediate implant-based reconstruction. Preventive measures may be taken in advance with the assistance of healthcare providers if necessary.