Breast Reconstruction Use And Impact On Oncologic Outcomes Amongst Inflammatory Breast Cancer Patients: A Systematic Review

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Introduction: Women with inflammatory breast cancer (IBC) are often advised against breast reconstruction due to concerns about recurrence and poor long-term survival. Our study aims to characterize trends and predictors for breast reconstruction use, and its impact on oncologic outcomes amongst women with IBC. Methods: We systematically searched MEDLINE, Embase, and the Cochrane Library for all studies published up to February 1, 2022, using MeSH and EMTREE headings with free text combinations. Randomized controlled trials and cohort studies comparing women diagnosed with IBC undergoing a mastectomy with or without breast reconstruction were evaluated. Results: The initial search yielded a total of 203 studies, of which 8 eligible studies, all retrospective cohort studies, reporting 2,393 cases of breast reconstruction in 25,082 women with IBC were included in the final review. In the past two decades, reconstruction rates have risen from 6.3% to 12.3%, with younger age, higher income, private insurance, and living in metropolitan areas being associated with reconstruction. Four studies found no difference between women undergoing vs not undergoing reconstruction for overall survival or local recurrence rates, while two studies found improved overall survival amongst women who underwent reconstruction. Immediate breast reconstruction was associated with increased risk of postoperative complications in two studies, compared to no or delayed reconstruction. Delays in starting adjuvant therapy were not different between the groups. Conclusion: Breast reconstruction after mastectomy may be reasonable to consider for select patients with IBC who desire the procedure, as it is not associated with worse survival or increased local recurrence.

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