Use of autologous fat grafting for breast reconstruction: A systematic review with meta-analysis of oncological outcomes: Agha RA, Fowler AJ, Herlin C, et al (Pinderfields Hosp, Wakefield, UK; QMUL, UK; Lapeyronie Univ Hosp, Montpellier, France; Et al) J Plast Reconstr Aesthet Surg 68:143-161, 2015

Background. -There is growing interest in the use of autologous fat grafting (AFG) for breast reconstruction. Concerns have been raised regardingits 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 (CRD4201 3005254). 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. Identificat on and selection of studies: Title and abstract screening and full text assessment undertakenseparately 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 temp 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 1/4 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 150 Breast Diseases: A Year Book Quarterly Vol 26 2 2015 radiological follow-up is required. Further research is necessary to confirm oncological ramifications.