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Systematic review: Oncological safety of reconstruction with fat grafting in breast cancer outcomes

  • Pietro Gentile
    Correspondence
    Corresponding author at: 00173, Via Montpellier 1, Rome Italy.
    Affiliations
    Associate Professor of Plastic and Reconstructive Surgery, Department of Surgical Science, Medical School, “Tor Vergata” University, Rome, 00133, Italy

    Scientific Director of Academy of International Regenerative Medicine & Surgery Societies (AIRMESS), 1201 Geneva, Switzerland

    Top Italian Scientists (H-Index >30)
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  • Valerio Cervelli
    Affiliations
    Full Professor of Plastic and Reconstructive Surgery, Department of Surgical Science, Medical School, “Tor Vergata” University, Rome, 00133, Italy
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Published:August 22, 2022DOI:https://doi.org/10.1016/j.bjps.2022.08.026

      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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