Relationship Between Different Margin Width And Risk Of Local Recurrence In Breast-conserving Surgery After Neoadjuvant Chemotherapy:A Meta-analysis

Objective: Neoadjuvant chemotherapy is increasingly used for the treatment of breast cancer,and some studies have reported that the width of margin is a risk factor for local disease recurrence(LR)in breast-conserving surgery(BCS)breast cancer surgery after neoadjuvant chemotherapy(NAC).The purpose of this study was to investigate the relationship between the risk of local recurrence of different margin widths of BCS after NAC.Methods: Systematic evaluation according to the PRISMA statement,with the keywords "Breast Neoplasm","Neoadjuvant Therapy","Mastectomy,Segmental","Margins of Excision","Neoplasm Recurrence,Local",searched in Pubmed,Embase database,and the eligible clinical studies were included in the analysis,and finally statistical analysis was performed using R-3.2.4 statistical analysis software.Results: According to the search strategy,a total of 114 articles were retrieved.11 articles and 79 non-conforming documents were excluded by reading the article title and abstract,and the remaining 24 articles were intensively read,according to the inclusion criteria and exclusion criteria,979 patients from 9 studies were included in the study.According to the width of the margin,the study was divided into two groups for statistical analysis: group1: >0mm;group2: ≥ 2mm.The local recurrence rate of the margin >0 mm group was 0.06(95% CI 0.03-0.10),and the local recurrence rate of the margin of ≥2 mm group was LRR=0.05(95% CI: 0.02-0.09),regardless of the margin factor,the overall local recurrence The rate is LRR=0.06(95% CI 0.03-0.08).Conclusions: Appropriate selection of appropriate patients,BCS after breast cancer patients with NAC is safe and feasible,In this meta-analysis,the local recurrence rate with a margin of ≥2 mm was lower than the negative margin,which may be insufficient for patients with breast-conserving surgery after neoadjuvant chemotherapy,but the specific margin of the margin still requires further clarification and refinement of large-sample,multi-center clinical trials.