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Breast Reconstruction Use And Impact On Oncologic Outcomes Amongst Inflammatory Breast Cancer Patients: A Systematic Review

2023· review· en· W4366142257 on OpenAlexaff
Ananya Gopika Nair, David W. Lim

Bibliographic record

VenueJournal of the American College of Surgeons · 2023
Typereview
Languageen
FieldMedicine
TopicBreast Implant and Reconstruction
Canadian institutionsWomen's College HospitalUniversity of Toronto
Fundersnot available
KeywordsMedicineBreast cancerInflammatory breast cancerOncologyCancerInternal medicineBreast reconstructionGeneral surgeryIntensive care medicine

Abstract

fetched live from OpenAlex

Introduction: Women with inflammatory breast cancer (IBC) are often advised against breast reconstruction due to concerns about recurrence and poor long-term survival. Our study aims to characterize trends and predictors for breast reconstruction use, and its impact on oncologic outcomes amongst women with IBC. Methods: We systematically searched MEDLINE, Embase, and the Cochrane Library for all studies published up to February 1, 2022, using MeSH and EMTREE headings with free text combinations. Randomized controlled trials and cohort studies comparing women diagnosed with IBC undergoing a mastectomy with or without breast reconstruction were evaluated. Results: The initial search yielded a total of 203 studies, of which 8 eligible studies, all retrospective cohort studies, reporting 2,393 cases of breast reconstruction in 25,082 women with IBC were included in the final review. In the past two decades, reconstruction rates have risen from 6.3% to 12.3%, with younger age, higher income, private insurance, and living in metropolitan areas being associated with reconstruction. Four studies found no difference between women undergoing vs not undergoing reconstruction for overall survival or local recurrence rates, while two studies found improved overall survival amongst women who underwent reconstruction. Immediate breast reconstruction was associated with increased risk of postoperative complications in two studies, compared to no or delayed reconstruction. Delays in starting adjuvant therapy were not different between the groups. Conclusion: Breast reconstruction after mastectomy may be reasonable to consider for select patients with IBC who desire the procedure, as it is not associated with worse survival or increased local recurrence.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.004
metaresearch head score (Gemma)0.023
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Systematic review · Consensus signal: Systematic review
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.007
Threshold uncertainty score0.021

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0040.023
Meta-epidemiology (narrow)0.0010.001
Meta-epidemiology (broad)0.0060.005
Bibliometrics0.0070.010
Science and technology studies0.0000.001
Scholarly communication0.0020.002
Open science0.0010.001
Research integrity0.0010.001
Insufficient payload (model declined to judge)0.0030.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.030
GPT teacher head0.316
Teacher spread0.286 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designSystematic review
Domainnot available
GenreReview

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations0
Published2023
Admission routes1
Has abstractyes

Explore more

Same venueJournal of the American College of SurgeonsSame topicBreast Implant and ReconstructionFrench-language works237,207