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. 2023 Dec 29;13(1):217.
doi: 10.3390/jcm13010217.

Impact of Adjuvant Radiotherapy on Free Flap Volume in Autologous Breast Reconstruction: A Scoping Review

Pablo Pfister  1 , Seraina L C Müller  1 , Anna-Lena Eberhardt  2 , Medea Rodriguez  1 , Nadia Menzi  1 , Martin Haug  1   3 , Dirk J Schaefer  1   3 , Elisabeth A Kappos  1   3 , Tarek Ismail  1   3
Affiliations

Impact of Adjuvant Radiotherapy on Free Flap Volume in Autologous Breast Reconstruction: A Scoping Review

Pablo Pfister et al. J Clin Med. .

Abstract

In autologous breast reconstruction, a sufficient flap volume is fundamental to restore breast shape and ensure an aesthetic outcome. After mastectomy, postoperative irradiation is regularly indicated in the oncological treatment algorithm. When administering radiation therapy after autologous reconstruction, the tissue transferred is inherently irradiated. Although there is evidence that points to a reduction in flap volume after adjuvant radiotherapy, the data have been contradicting and inconclusive. To address this anecdotal evidence, we performed a scoping review of the current literature that addresses the effect of radiotherapy on breast flap volume. Six two-armed studies, comprising a total of 462 patients, reported on the effect of adjuvant radiotherapy on free flap volume changes. Of those, two studies found a significant negative impact of radiotherapy on free flap volume, while the other four studies did not. Reported flap volume changes ranged from no change to a reduction of 26.2%, measured up to two years postoperatively. The selected studies contain varying patient numbers, follow-up timepoints, types of flaps, and measuring methods, contributing to a relatively high heterogeneity. While we present some evidence suggesting a significant impact of adjuvant radiotherapy on breast flap volume, future studies are needed to further investigate this potential correlation.

Keywords: adjuvant radiotherapy; breast reconstruction; flap volume; free flap.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Preferred Reporting Items for Systematic review and Meta-analyses (PRISMA) 2020 flow diagram for new systematic reviews, including searches of databases, registers, and other sources. Cochrane CENTRAL, the Cochrane Central Register of Controlled Trial.
See this image and copyright information in PMC

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