Journal article
"Anticancer Agents and Their Impact on Breast Reconstruction: A Guide for Plastic Surgeons Based on Systematic Review and Expert Consensus"
Plastic and reconstructive surgery (1963), Vol.157(2), pp.227-236
02/2026
DOI: 10.1097/PRS.0000000000012325
PMID: 40707174
Abstract
Adjuvant anticancer agents are often prescribed to patients with breast cancer to reduce recurrence risk and improve outcomes. Many patients take these medications during primary and staged breast reconstruction. This study aims to: 1. Present a review of existing literature on adjuvant anticancer medications and whether, based on side effects and risks, they should be held for elective, medically necessary reconstructive procedures, and 2. Report expert multidisciplinary consensus recommendations for commonly prescribed agents.
Following PRISMA 2020 guidelines, we queried three databases for relevant keywords (e.g., "breast reconstruction" AND "anticancer agent"). Inclusion criteria encompassed studies on anticancer agents and breast reconstruction; non-English articles and reviews were excluded. Perioperative recommendations were developed based on the review and expert consensus.
The query identified 1,188 papers, which narrowed to 19 included articles involving 5,793 patients. Included studies discussed tamoxifen (18), aromatase inhibitors (8), trastuzumab (2), and pertuzumab (1). No studies examined agents like GnRH agonists or pembrolizumab. Based on the review and consensus, we created guidelines on when to hold medications preoperatively. Expert consensus indicated that most do not need to be held, though preoperative lab tests for leukocytes and/or platelets are advised in some cases.
Plastic Surgeons frequently treat patients on anticancer agents. Rapid research advancements can make it challenging to understand their impact on perioperative risk and surgical outcomes. While ever-changing, guidelines in this paper can help plastic surgeons with medication management and perioperative counseling for primary and revision breast reconstruction procedures.
Details
- Title: Subtitle
- "Anticancer Agents and Their Impact on Breast Reconstruction: A Guide for Plastic Surgeons Based on Systematic Review and Expert Consensus"
- Creators
- Emily E Zona - University of Wisconsin–MadisonSarah M Thornton - University of Wisconsin–MadisonEllen C Via - University of Wisconsin–MadisonMark E Burkard - University of Wisconsin–MadisonBrett F Michelotti - University of Wisconsin–MadisonSamuel O Poore - University of Wisconsin–MadisonMeeghan A Lautner - University of Wisconsin–MadisonJacqueline S Israel - University of Wisconsin–Madison
- Resource Type
- Journal article
- Publication Details
- Plastic and reconstructive surgery (1963), Vol.157(2), pp.227-236
- DOI
- 10.1097/PRS.0000000000012325
- PMID
- 40707174
- NLM abbreviation
- Plast Reconstr Surg
- ISSN
- 1529-4242
- eISSN
- 1529-4242
- Language
- English
- Electronic publication date
- 07/22/2025
- Date published
- 02/2026
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984865444002771
Metrics
8 Record Views