Summary
Background
Autologous fat grafting (AFG) has become a commonly used procedure for breast reconstruction
(BR) after cancer removal. Nevertheless, oncological considerations remain for AFG
after breast cancer surgery.
Objectives
This article aims to evaluate the oncological safety of AFG in BR and its effect on
disease-free survival (DFS) and local-regional recurrences (LRR).
Methods
A systematic review regarding the use of AFG in BR to identify a difference in incidence
rates of LRR and DFS between patients who had AFG and controls was performed using
PubMed, MEDLINE, Embase, PreMEDLINE, Ebase, CINAHL, PsycINFO, Clinicaltrials.gov,
Scopus, and Cochrane databases. The protocol was developed following the Preferred
Reporting for Items for Systematic Reviews-Protocols (PRISMA-P) guidelines. The included
studies had to match predetermined criteria according to the PICOS approach.
Results
A total of 11 studies were included. Seven studies reported LRR, and 5 studies reported
DFS in 5,886 patients. Our systematic review showed that AFG was not associated with
increased LRR and DFS. Pooled hazard ratios (HRs) (95% confidence intervals [CIs])
for LRR and DFS were 1.26 (0.90–1.76) and 1.27 (0.96–1.69), respectively.
Conclusions
AFG can, therefore, be performed safely in BR after breast cancer. Further, randomized
controlled trials and related systematic reviews, as well as evidence-based medicine
(EBM) studies of level 1, are required to consolidate the results of the studies identified
in this systematic review.
Keywords
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Article info
Publication history
Published online: August 22, 2022
Accepted:
August 17,
2022
Received:
June 7,
2022
Identification
Copyright
© 2022 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
