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Updated: Aug 26, 2026
Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
Published on: May 17, 2024
Efficacy of Immediate Lymphatic Reconstruction after Breast Cancer Surgery: A Systematic Review and Time-course
Hong-Jie Chang1, Kuan-Yu Chen1, Wen-Kuan Chiu2,3
1Taipei Medical University, School of Medicine, College of Medicine, Taiwan, Taipei.
Background:
Immediate lymphatic reconstruction (ILR) is a prophylactic approach for breast cancer-related lymphedema (BCRL) following axillary lymph node dissection (ALND). This study assessed the preventive effect of ILR by evaluating data from prior studies, with a focus on time-course dynamics.
Methods:
A systematic review and meta-analysis was performed of 17 studies comparing ALND plus ILR with ALND alone. The primary outcome was BCRL incidence. Pooled risk ratios (RRs) and 95% confidence intervals (CIs) were calculated using a random-effects model. Subgroup analyses were stratified by follow-up duration (1-48 months).
Results:
ILR significantly reduced BCRL incidence (RR: 0.37; 95% CI: 0.28-0.49). Time-stratified analysis indicated that the prophylactic effect was robust within the first 2 years postoperatively, peaking at 12 months (RR: 0.13; 95% CI: 0.04-0.46). Limited data beyond 2 years necessitates further studies to clarify long-term results.
Conclusion:
ILR reduces BCRL risk, remaining a valuable preventive strategy for breast cancer patients. This benefit remains unclear in the long term, highlighting the need for further high-quality trials with extended surveillance.
