{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T19:10:18Z","timestamp":1790190618185,"version":"4.1.0"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"6","license":[{"start":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T00:00:00Z","timestamp":1758758400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T00:00:00Z","timestamp":1758758400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100015638","name":"Japanese Breast Cancer Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015638","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004721","name":"The University of Tokyo","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004721","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Breast Cancer"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In immediate expander\/implant reconstruction, postmastectomy radiation therapy (PMRT) can be administered at two different time points: during tissue expander insertion or after exchange with an implant. The optimal timing for PMRT remains unclear. We conducted a systematic review and meta-analysis to evaluate the impact of PMRT timing on the outcomes of patients with breast cancer undergoing two-stage expander\/implant breast reconstruction.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A literature review of articles in English and Japanese up to March 2021 was performed using PubMed\/MEDLINE, the Cochrane Library, and Ichushi-Web. Studies comparing the timing of PMRT in patients with breast cancer undergoing immediate two-stage expander\/implant breast reconstructions and PMRT were included. The assessed outcomes included major complications, reconstruction failure, cosmesis, capsular contractures, and local recurrence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Eleven studies encompassing 1,628 cases were identified. These included one prospective cohort study, one prospective case\u2013control study, and nine retrospective cohort studies. No significant differences were observed in major complications between PMRT to expander and PMRT to implant (odds ratio [OR] 1.11, 95% confidence intervals [CI] 0.72\u20131.73,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.64). Reconstruction failure was more prevalent in the expander group (OR 2.33, 95% CI 1.43\u20133.82,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.0007), while severe capsular contractures occurred less frequently in the expander group (OR 0.33, 95% CI 0.12\u20130.92,\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.03).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>PMRT to expander was associated with higher reconstruction failure and lower severe capsular contracture rates, with no significant differences in major complications by timing. There is insufficient evidence to favor one approach over the other.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s12282-025-01785-5","type":"journal-article","created":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T12:12:45Z","timestamp":1758802365000},"page":"1159-1168","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Timing of postmastectomy radiation therapy in two-stage expander\/implant-based breast reconstruction: a systematic review and meta-analysis for the 2022 Japanese breast cancer society clinical practice guideline"],"prefix":"10.1007","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1539-4298","authenticated-orcid":false,"given":"Mami","family":"Ogita","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Subaru","family":"Sawayanagi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruka","family":"Jinnouchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michio","family":"Yoshimura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chikako","family":"Yamauchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoko","family":"Sanuki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasushi","family":"Hamamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimiko","family":"Hirata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariko","family":"Kawamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaka","family":"Yamamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigehira","family":"Saji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuya","family":"Toyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,9,25]]},"reference":[{"key":"1785_CR1","doi-asserted-by":"publisher","first-page":"772","DOI":"10.1097\/PRS.0000000000002536","volume":"138","author":"T Zhong","year":"2016","unstructured":"Zhong T, Hu J, Bagher S, Vo A, O\u2019Neill AC, Butler K, et al. 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He is an advisory board member of AstraZeneca, MSD, Pfizer, and Daiichi Sankyo. SS received research grants from Taiho, Eisai, Chugai, Takeda, MSD, Astra Zeneca, Daiichi Sankyo, Gilead, Eli Lilly, Sanofi, and honoraria from Chugai, Kyowa Kirin, MSD, Novartis, Eisai, Takeda, Daiichi Sankyo, Eli Lilly, Astra Zeneca, Pfizer, Taiho, Ono, Nipponkayaku, Gilead, and Exact Sciences. He is an advisory board member of Chugai\/Roche, Astra Zeneca, Eli Lilly, Pfizer, Kyowa Kirin, Daiichi Sankyo, and MSD and an executive board member of JBCRG, JBCS, JSMO, and BIG. TT received honoraria from Chugai, Daiichi Sankyo, Pfizer, MSD, Lilly, Novartis, and Taiho. H declare no conflict of interest. The authors declare no conflicts of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This article does not contain any studies with human participants or animals performed by any of the authors.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Research involving human and\/or animals participants"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}