Cosmetic Effects And Prognosis Of Breast-conserving Therapy For Central Located Breast Cancer:A Meta-analysis

Objective:To systematically evaluate the cosmetic effect and prognosis of breast conserving surgery for breast cancer in central region,and to provide evidence-based medical basis for clinical decision-making,practice and surgical guidelines.Methods:We performed a systematic search of Wanfang database,Weipu database,literature database of Chinese biomedical journals,PubMed,EMBASE,Cochrane Library,Medline,Springer link,Wiley Online Library databases with language restrictions in English and Chinese and year of publication between from January 1995 to December 2018.To collect and include the relevant research on cosmetic effect and prognosis of central located breast cancer after conservation therapy,two researchers independently screened literature and extracted data,and conducted quality evaluation.Counting data were presented by combined percentage and 95%confidence interval(95%CI).Heterogeneity was analyzed by Homogeneity test and I~2.Incidence of the included studies was combined by single-group rate meta-analysis method.Statistical analysis was carried out by using Meta package of R Studio.Results:A total of 16 papers were included in breast conserving therapy for breast cancer in central region,and 750 patients met the criteria accumulatively.Meta-analysis showed that:(1)the excellent rate of cosmetic effect after breast-conserving treatment for early central breast cancer was 0.48[95%CI(0.35,0.61)],the excellent and good rate of cosmetic effect was 0.91[95%CI(0.87,0.93)].In subgroup analysis,the excellent and good rate of cosmetic effect of breast conservation treatment by oncoplastic breast conserving surgery was 0.95[95%CI(0.86,1.00)]and the excellent and good rate of cosmetic effect by common breast-conserving surgery was 0.88[95%CI(0.80,0.95)].The incidence of local recurrence was 0.02[95%CI(0.00,0.05)].the incidence of positive margin was 0.07[95%CI(0.03,0.12)].The incidence of distant recurrence was 0.03[95%CI(0.02,0.07)].Conclusion:Centrally located breast carcinoma patients have been treated with standardized breast-conserving treatment to achieve safe treatment of the tumor and to maintain the aesthetic appearance of the postoperative breast.