Use of autologous fat grafting for breast reconstruction: A systematic review with meta-analysis of oncological outcomes

Abstract : BACKGROUND: There is growing interest in the use of autologous fat grafting (AFG) for breast reconstruction. Concerns have been raised regarding its effectiveness and safety. OBJECTIVE: The primary objective was to determine the oncological, clinical, aesthetic and functional, patient reported, process and radiological outcomes of AFG. METHODS: A protocol was published on PROSPERO (CRD42013005254). Types of studies: All original studies. TYPES OF PARTICIPANTS: Women undergoing reconstruction after surgery for breast cancer. Types of Interventions: AFG techniques for reconstruction. Types of outcome measures: Oncological, clinical, aesthetic and functional, patient reported, process and radiological. Search terms and keywords: The search strategy was devised to find papers regarding AFG for breast reconstruction. DATA SOURCES: Electronic databases were searched from 1st January 1986 to 31st March 2014 including: PubMed, MEDLINE, EMBASE, SCOPUS, The Cochrane Library, and clinical trial registries. Identification and selection of studies: Title and abstract screening and full text assessment undertaken separately by independent researchers. Data extraction, collection and management: Data extracted by two researchers and stored in a standardised database. RESULTS: 35 studies were included (3624 patients) with a high degree of patient and surgeon satisfaction over a mean of 1.9 sessions at 18 month follow-up. Fat necrosis was the commonest reported complication (4.4%), biopsy of a subsequent breast lump was required in 2.7% and an interval mammogram in 11.5%. The weighted mean recurrence rate was 4.4% at 24.6 months. Meta-analysis of comparative studies showed no significant difference in oncological event rates between AFG and non-AFG groups (p=0.10). CONCLUSION: AFG is a potentially useful reconstructive tool, has a relatively low complication rate, with the majority of patients and clinicians satisfied or very satisfied with the results. Long term clinical and radiological follow-up is required. Further research is necessary to confirm oncological ramifications.
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Contributeur : Anthony Herrada <>
Soumis le : jeudi 23 mai 2019 - 13:26:20
Dernière modification le : mardi 28 mai 2019 - 09:42:07

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Riaz Agha, Alexander Fowler, Christian Herlin, Tim Goodacre, Dennis Orgill. Use of autologous fat grafting for breast reconstruction: A systematic review with meta-analysis of oncological outcomes. Journal of Plastic, Reconstructive and Aesthetic Surgery, Elsevier, 2015, 68 (2), pp.143-161. ⟨10.1016/j.bjps.2014.10.038⟩. ⟨hal-02137913⟩

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