The primary aim was to synthesize all the available evidence to support the safety of immediate breast reconstruction following NACT by comparing the post-operative course of patients. The delivery of adjuvant treatment such as TDM1, and most significantly, can de-escalate surgery from a mastectomy to breast conserving surgery. The impact of NACT on surgical outcomes are highly variable, it is generally considered safe practice to perform an IBR following NACT. Patient and oncological factors are taken into consideration prior to selecting the most suitable reconstruction for each patient. Delayed and problematic wound healing has been seen in animal studies secondary to chemotherapy drugs. The objective of this systematic review and meta-analysis is to assess the impact of NACT on patients undergoing autologous or implant reconstruction following NACT. The type of reconstruction and reported complications were recorded for all patients. 

In conclusion, the results that were recorded showed a moderate, but not significant, increase in flap loss following NACT compared with controls (RR: 1.23, 95% CI 0.70 to 2.18, p = 0.47; I2 = 0%). Immediate breast reconstruction after NACT is a safe procedure with an acceptable post-operative complication profile.NACT did not increase the risk of complications after immediate breast reconstructions (risk ratio [RR]: 0.91, 95% CI 0.74 to 1.11, p = 0.34).

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