Autologous versus prosthetic reconstruction for women with breast cancer who will undergo post-reconstruction radiotherapy

Abstract

INTRODUCTION Radiotherapy is frequently used after breast reconstruction in patients with locally advanced breast cancer or metastases in axillary lymph nodes. However, there might be differences between autologous and prosthetic reconstruction in terms of effectiveness and safety of post-reconstruction radiotherapy. METHODS To answer this question we searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach. RESULTS AND CONCLUSIONS We identified five systematic reviews including nine primary studies overall, of which all were observational studies. We concluded that in patients who will undergo post reconstructive radiotherapy, autologous breast reconstruction could reduce reoperations due to general complications compared to prosthetic breast reconstruction. However, it probably increases the risk of skin or flap necrosis. It is not clear whether there are differences in other outcomes as the certainty of evidence has been assessed as very low.

Keywords

• post-mastectomy radiotherapy
• autologous breast reconstruction
• prosthetic breast reconstruction
• postoperative morbidity
• epistemonikos
• grade