Oncoplastic Reduction Mammoplasty For Macromastia In Patients With Early Stage Breast Cancer:A Single Arm Meta-Analysis

Objective: Reduction Mammaplasty(RM)is not only used in the treatment of galactophagia with early breast cancer,but also completely resected the early breast tumor.The postoperative appearance of the mammoplasty will be more beautiful in the patients undergoing mastectomy.Clinical studies on the use of RM in patients with early breast cancer with macromammary disease have been increasing in recent years,but are trapped by the indications of RM,and the number of patients involved in these clinical studies is often relatively small.The low number of patients directly limits the universality and authority of the final conclusion.Therefore,we carried out this meta-analysis study by analyzing the incidence of postoperative complications,local recurrence rate,positive rate of incision margin,survival rate of more than 5 years after the application of RM in patients with early breast cancer with giant breast disease and the satisfaction rate of patients after operation to evaluate the clinical efficacy of the operation.In order to guide the application of this technique in clinical practice,more reliable conclusions can be obtained through the analysis of large samples.Methods: To search the national and international databases of major papers and periodicals.The time is set from the construction of the library to December 2018.The key words are "Giant mammary disease","Breast Neoplasms","Gigantomastia","Mammoplasty","Reduction Mammaplasty" and "Breast cancer".A single-group meta-analysis was conducted by published research papers on the application of RM in patients with early breast cancer with giant breast cancer which were searched.The statistical software was used in our study is Stata data processing software and the version of it is 14.0.A comprehensive evaluation of the heterogeneity and publication bias of the literature was carried out by Stata.The random effect model or fixed effect model was used to analyse the original data to get the final conclusion.Results: Through the retrieval of the database,a total of 22 papers were included in meta-analysis,involving 1638 patients.And 743 patients of them in North America,74 patients of them in South America,821 patients of them in Europe.According to thecombined analysis of Stata version 14.0 software,the incidence of postoperative complications in patients with early breast cancer complicated with giant breast cancer treated with RM was 0.25(95% CI: 0.19,0.32),the local recurrence rate was 0.04(95%CI: 0.03,0.06),the positive rate of incision margin was 0.08(95% CI: 0.06,0.09),the survival rate was 0.62(95% CI: 0.31,0.89),and the satisfaction rate of patients after operation was 0.92(95% CI: 0.89,0.95).The incidence of postoperative complications,the local recurrence rate,the positive rate of incision margin,the survival rate of more than 5 years after operation and the published bias of postoperative satisfaction rate were0.06,0.42,0.73,0.66,0.78,respectively.And the results showed that there was no publication bias in this meta-analysis.Conclusion: Combined with the typical case reports of our hospital,the clinical efficacy of RM in the treatment of early breast cancer with giant breast disease was significant.