Patient Reported Outcome and Quality of Life After Delayed Breast Reconstruction - An RCT Comparing Different Reconstructive Methods in Radiated and Non-radiated Patients

Brorson, Fredrik; Elander, Anna; Thórarinsson, Andri; Hansson, Emma

doi:10.1016/j.clbc.2022.09.004

Cited by 8 publications

(5 citation statements)

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“…The study comparing immediate and delayed breast reconstruction was conducted in 1983 when breast reconstruction was much less common than it is today. Four studies compared different categories of breast reconstruction techniques head-to-head (Table 3), one Dutch [6] and three Swedish, from three different centres [7][8][9][10][11].…”

Section: Resultsmentioning

confidence: 99%

“…Such professional conflicts should not be allowed to impede high quality studies. • LTD versus LD versus TRAM (SVEA) [7,8] • DIEP versus LD in radiated patients and tissue expander + implant versus thoracodorsal flap and implant in non-radiated patients (GoBreast) [10,11] • DIEP versus . implant based breast reconstruction in non-radiated patients [9,12] Key issue: Comparison of immediate and delayed breast reconstruction…”

Section: Discussionmentioning

confidence: 99%

“…As a consequence, the external validity of the study might have been affected, as only patients who prefer autologous reconstruction were likely to accept randomisation [12] and the results therefore are not generalisable to the clinical population. Patients' preferences could also reduce internal validity as randomisation to the (non-) preferred strategy could affect both adherence to the protocol (reluctant acquiescence phenomenon) and outcome measurements [10]. Moreover, the concept of randomising patients to different categories of reconstruction might contradict the spirit of patient-centred care [27].…”

Section: Anaestheticsmentioning

confidence: 99%

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A systematic review of randomised controlled trials in breast reconstruction

Hansson,

Larsson,

Uusimäki

et al. 2024

JPHS

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Background: For preference sensitive treatments, such as breast reconstructions, there are barriers to conducting randomised controlled trials (RCTs). The primary aims of this systematic review were to investigate what type of research questions are explored by RCTs in breast reconstruction, where have they been performed and where have they been published, and to thematise the research questions and thus create an overview of the state of the research field. Methods: Randomised controlled trials investigating any aspect of breast reconstructions were included. The PubMed database was searched with a pre-defined search string. Inclusion and data abstraction was performed in a pre-defined standardised fashion. For the purpose of this study, we defined key issues as comparison of categories of breast reconstruction and comparison of immediate and delayed breast reconstruction, when the thematisation was done. Results: A total of 419 abstracts were retrieved from the search. Of the 419, 310 were excluded as they were not RCTs concerning some aspect of breast reconstruction, which left us with 110 abstracts to be included in the study. The research questions of the included studies could more or less be divided into seven different themes inclusive of 2 key issues: Other issues – comparison of different categories of breast reconstruction, comparison of immediate and delayed breast reconstruction, surgical details within a category of breast reconstruction, surgical details valid for several categories of breast reconstruction, donor site management, anaesthetics, and non-surgical details. Only five studies compared key issues, and they all illustrate the challenges with RCTs in breast reconstruction. Conclusions: A total of 110 publications based on RCTs in breast reconstruction have been published. Seven themes of research questions could be identified. Only five studies have explored the key issues. Better scientific evidence is needed for the key issues in breast reconstruction, for example by implementing a new study design in the field.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Anaestheticsmentioning

confidence: 99%

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A systematic review of randomised controlled trials in breast reconstruction

Hansson,

Larsson,

Uusimäki

et al. 2024

JPHS

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“…[1][2][3][4][5] Autologous breast reconstruction (ABR) has continued to increase in popularity due to numerous factors, including improved cosmetic outcomes, patient satisfaction, and quality of life. 1,[6][7][8][9][10][11] As the field has transformed over the past 50 years, the number of peer-reviewed publications in breast reconstruction has drastically increased to reflect new insights and trends.Bibliometric analyses provide perspective on growth, impact, trends, and gaps in scientific literature. 12,13 Article citations serve as a relevant proxy to gauge an article's impact and relevance to clinical practice.…”

mentioning

confidence: 99%

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confidence: 99%

The 100 Most-cited Articles in Autologous Breast Reconstruction: A Bibliometric Analysis

Ruccia,

Elmorsi,

Dhandapani

et al. 2024

Plastic and Reconstructive Surgery - Global Open

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Background: Autologous breast reconstruction has continued to increase in popularity and witnessed significant advancements in aesthetic outcomes, patient satisfaction, and improved quality of life. We performed the first bibliometric analysis focused only on the 100 most-cited autologous breast reconstruction articles to characterize any emerging trends and assess the methodological quality of these studies. Methods: The 100 most-cited articles in autologous breast reconstruction were identified on Web of Science, across all available journals and years. Study details, including the citation count, main subject, and outcome measures, were extracted from each article, and the level of evidence was also assessed. Results: The 100 most-cited articles in autologous breast reconstruction were cited by a total of 21,194 articles. Citation per article ranged significantly from 112 to 1123 (mean, 211.9). Overall, most of the top-cited articles are case reports/series (n = 32, mean citations = 243.2) and cohort studies (n = 30, mean citations = 211.2). This is closely followed by case-control studies (n = 29, mean citations = 183.6). Only four studies achieved level 1 status, underscoring a lack of high-quality methodological research in the field. Most studies (n = 72) highlighted autologous breast reconstruction outcomes, whereas 12 focused on its indications. There were nine studies exploring surgical techniques, and seven studies addressing the autologous breast reconstruction surgical anatomy. Conclusions: Overall, most of the influential articles in autologous breast reconstruction literature are of lower-level evidence. Contemporary research should focus on enhancing the study designs and measure clinical and patient-reported outcomes with validated tools, such as BREAST-Q.

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