Challenges and outcomes of breast reconstruction in advanced-stage breast cancer: a comprehensive review

Post-mastectomy breast reconstruction plays a crucial role in the psychological well-being and long term quality of life of patients with breast cancer. However, its role in advanced stages (stages III-IV) remains debatable. To analyze the clinical outcomes and potential benefits of breast reconstruction in patients with advanced-stage breast cancer, a systematic review of studies on the reconstructive approach published between January 2018 and March 2025 was conducted. There is a marked paucity of studies focused on this topic, and most available data derive from small case series or observational reports, which suggest that breast reconstruction may be technically feasible and associated with acceptable complication rates in selected cases. Nevertheless, the impact of aggressive adjuvant therapies, such as chemotherapy and radiotherapy, on final aesthetic outcomes in this population remains poorly defined. There is an urgent need for prospective studies evaluating both clinical outcomes and patient satisfaction to guide surgical decision-making in women with advanced-stage breast cancer.