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Volume 15
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10.3390/jcm15010341
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Systematic Review

Surgical Timing and Safety of Breast Cancer Operations After COVID-19: A Prospective-Only Meta-Analysis of Cohort Studies

by
Ioana-Georgiana Cotet
1,2,
Diana-Maria Mateescu
1,
Dragos-Mihai Gavrilescu
3,*,
Andrei Marginean
4,*,
Stefania Serban
1,
Adrian-Cosmin Ilie
5,
Cristina Guse
1,
Ana-Maria Pah
6,
Marius Badalica-Petrescu
6,
Stela Iurciuc
6,
Maria-Laura Craciun
6,
Adina Avram
6 and
Cristina Tudoran
2,7,8
1
Department of General Medicine, Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
2
Centre of Molecular Research in Nephrology and Vascular Disease, University of Medicine and Pharmacy “Victor Babes” Timisoara, Eftimie Murgu Square, Nr. 2, 300041 Timisoara, Romania
3
Department of Orthodontics, Dental District, Strada Zăgazului Nr. 3, One Floreasca Vista, Sector 1, 014261 Bucharest, Romania
4
Department of Surgery, “Dr. Victor Popescu” Emergency Military Hospital, 9 Gheorghe Lazăr Street, 300080 Timișoara, Romania
5
Department of Public Health and Sanitary Management, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
6
Cardiology Department, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
7
Department VII, Internal Medicine II, Discipline of Cardiology, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square, Nr. 2, 300041 Timisoara, Romania
8
County Emergency Hospital “Pius Brinzeu”, L. Rebreanu, Nr. 156, 300723 Timisoara, Romania
*
Authors to whom correspondence should be addressed.
J. Clin. Med. 2026, 15(1), 341; https://doi.org/10.3390/jcm15010341
Submission received: 17 November 2025 / Revised: 28 December 2025 / Accepted: 30 December 2025 / Published: 2 January 2026
(This article belongs to the Special Issue Sequelae of COVID-19: Clinical to Prognostic Follow-Up)
Versions Notes

Abstract

Background: The COVID-19 pandemic raised uncertainties regarding the safe timing of breast cancer surgery after SARS-CoV-2 infection, and robust prospective evidence has remained limited. Methods: We conducted a systematic review and meta-analysis of prospective cohort studies (2020–2024) investigating postoperative outcomes in breast cancer patients with confirmed SARS-CoV-2 infection ≤90 days before surgery versus contemporaneous non-infected controls treated at the same institutions and in the same period. PROSPERO CRD420251174613. Random-effects models (DerSimonian–Laird with Hartung–Knapp adjustment) were used to pool odds ratios (ORs) and 95% confidence intervals (CIs). Study quality was assessed with the Newcastle–Ottawa Scale, and certainty of evidence was rated using GRADE. Results: Twelve prospective cohort studies, including 7812patients, compared breast cancer surgery after recent confirmed SARS-CoV-2 infection over 90 days with contemporaneous non-infected controls treated at the same centres. Overall, recent infection was associated with higher 30-day postoperative complications (Clavien–Dindo ≥ II)compared to. non-infected patients (OR 2.01, 95% CI 1.44–2.81) and increased venous thromboembolism (3.6%vs. 1.2%; OR 3.12, 95% CI 1.29–7.55). Early surgery 14 days after infection carried the highest risk of complications (OR 4.38, 95 CI 2.31–8.30), whereas operations performed ≥6 weeks yielded outcomes comparable to non-infected controls (OR 1.03, 95 CI 0.81–1.31); 30-day mortality remained very low (0.3). Conclusions: Breast cancer surgery after SARS-CoV-2 infection is associated with excess perioperative risk only when performed within the first two weeks. Delaying surgery to approximately six weeks minimises complications and VTE without compromising short-term safety.
Keywords: breast cancer; COVID-19; SARS-CoV-2; surgery timing; postoperative complications; venous thromboembolism; meta-analysis breast cancer; COVID-19; SARS-CoV-2; surgery timing; postoperative complications; venous thromboembolism; meta-analysis

Share and Cite

MDPI and ACS Style

Cotet, I.-G.; Mateescu, D.-M.; Gavrilescu, D.-M.; Marginean, A.; Serban, S.; Ilie, A.-C.; Guse, C.; Pah, A.-M.; Badalica-Petrescu, M.; Iurciuc, S.; et al. Surgical Timing and Safety of Breast Cancer Operations After COVID-19: A Prospective-Only Meta-Analysis of Cohort Studies. J. Clin. Med. 2026, 15, 341. https://doi.org/10.3390/jcm15010341

AMA Style

Cotet I-G, Mateescu D-M, Gavrilescu D-M, Marginean A, Serban S, Ilie A-C, Guse C, Pah A-M, Badalica-Petrescu M, Iurciuc S, et al. Surgical Timing and Safety of Breast Cancer Operations After COVID-19: A Prospective-Only Meta-Analysis of Cohort Studies. Journal of Clinical Medicine. 2026; 15(1):341. https://doi.org/10.3390/jcm15010341

Chicago/Turabian Style

Cotet, Ioana-Georgiana, Diana-Maria Mateescu, Dragos-Mihai Gavrilescu, Andrei Marginean, Stefania Serban, Adrian-Cosmin Ilie, Cristina Guse, Ana-Maria Pah, Marius Badalica-Petrescu, Stela Iurciuc, and et al. 2026. "Surgical Timing and Safety of Breast Cancer Operations After COVID-19: A Prospective-Only Meta-Analysis of Cohort Studies" Journal of Clinical Medicine 15, no. 1: 341. https://doi.org/10.3390/jcm15010341

APA Style

Cotet, I.-G., Mateescu, D.-M., Gavrilescu, D.-M., Marginean, A., Serban, S., Ilie, A.-C., Guse, C., Pah, A.-M., Badalica-Petrescu, M., Iurciuc, S., Craciun, M.-L., Avram, A., & Tudoran, C. (2026). Surgical Timing and Safety of Breast Cancer Operations After COVID-19: A Prospective-Only Meta-Analysis of Cohort Studies. Journal of Clinical Medicine, 15(1), 341. https://doi.org/10.3390/jcm15010341

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