Breast Reconstruction in De Novo Metastatic Breast Cancer: A Systematic Review

Background:. 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. Methods:. A systematic review was conducted...

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Main Authors: Alexzandra Mattia, BS, Mohammad Alomari, MD, Taliah Hyjazie, BSc, Nitya Devisetti, BS, Yizhuo Shen, BA, MMSc, Siba Haykal, MD, PhD
Format: Article
Language:English
Published: Wolters Kluwer 2025-06-01
Series:Plastic and Reconstructive Surgery, Global Open
Online Access:http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000006810
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Summary:Background:. 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. Methods:. 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. Results:. 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. Conclusions:. 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.
ISSN:2169-7574