Autologous fat grafting for radiation-induced breast damage: a systematic review of cosmetic and patient-reported outcome measures.
- 1School of Clinical Medicine, University of Cambridge, Hills Road, Cambridge, UK.
- 2University of Lausanne, Faculty of Biology and Medicine, Lausanne, Switzerland.
- 3Department of Plastic, Reconstructive and Aesthetic Surgery, Geneva University Hospitals, Geneva University, Geneva, Switzerland.
Abstract
Autologous fat grafting (AFG) is an increasingly popular adjunct used for reconstruction of the breast. Emerging evidence supports its role in both volumetric enhancement and therapeutic biomodulation, particularly in patients who have received radiotherapy. Data pertaining to aesthetic and patient-reported outcome measures (PROMs) of individuals who have received AFG after radiation therapy remain limited. This systematic review aims to synthesise the current evidence on this topic. An extensive literature search of PubMed, Embase, Cochrane Library, CINAHL, and Web of Science was conducted from inception until 22February 2026. All studies involving female patients (≥18 years) who had undergone both oncological radiotherapy and AFG for breast reconstruction, regardless of treatment sequence, were assessed. Primary outcomes of interest were aesthetic scores/PROMs, including validated measures such as BREAST-Q. Secondary outcomes included cyst formation rates following AFG procedures. A total of 23 studies, encompassing 960 irradiated patients, were included. PROMs were highly heterogeneous, with only 3 studies reporting numeric BREAST-Q scores, and the majority (n=17) using non-validated numerical rating scales to assess outcomes. Reported aesthetic outcomes and PROMs were generally favourable across the included studies. Moreover, amongst comparative studies evaluating AFG-containing protocols against non-AFG protocols (n=6), PROMs and aesthetic outcomes were generally more favourable in the former. In studies where pre-operative scores were also reported (n=6), improvements of 19.0-32.0% in aesthetic ratings, as well as in pain and post-operative satisfaction/psychosocial well-being ratings using the BREAST-Q instrument were observed. Cyst formation rates were generally low, with a weighted mean incidence of 5.4% reported across 7 studies. AFG use is associated with generally favourable quality of life and aesthetic outcomes amongst irradiated patients. However, the substantial heterogeneity of reported outcomes remains a limiting factor and demonstrates that there is a need for research to use standardised and validated PROMs.
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BibTeX
@article{lee2026autologous,
title = {{Autologous fat grafting for radiation-induced breast damage: a systematic review of cosmetic and patient-reported outcome measures.}},
author = {David Kwan Ryung Lee and Gaetan Nicolet and Krzysztof Sosnowski and Dave Osinachukwu Duru and Matteo Scampa and Dominik André-Lévigne},
journal = {Gland surgery},
year = {2026},
month = sep,
doi = {10.21037/gs-2026-0291},
url = {https://europepmc.org/article/MED/42996857},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Autologous fat grafting for radiation-induced breast damage: a systematic review of cosmetic and patient-reported outcome measures.
AU - David Kwan Ryung Lee
AU - Gaetan Nicolet
AU - Krzysztof Sosnowski
AU - Dave Osinachukwu Duru
AU - Matteo Scampa
AU - Dominik André-Lévigne
PY - 2026
DA - 2026/09/28
JO - Gland surgery
DO - 10.21037/gs-2026-0291
UR - https://europepmc.org/article/MED/42996857
AB - Autologous fat grafting (AFG) is an increasingly popular adjunct used for reconstruction of the breast. Emerging evidence supports its role in both volumetric enhancement and therapeutic biomodulation, particularly in patients who have received radiotherapy. Data pertaining to aesthetic and patient-reported outcome measures (PROMs) of individuals who have received AFG after radiation therapy remain limited. This systematic review aims to synthesise the current evidence on this topic. An extensive literature search of PubMed, Embase, Cochrane Library, CINAHL, and Web of Science was conducted from inception until 22February 2026. All studies involving female patients (≥18 years) who had undergone both oncological radiotherapy and AFG for breast reconstruction, regardless of treatment sequence, were assessed. Primary outcomes of interest were aesthetic scores/PROMs, including validated measures such as BREAST-Q. Secondary outcomes included cyst formation rates following AFG procedures. A total of 23 studies, encompassing 960 irradiated patients, were included. PROMs were highly heterogeneous, with only 3 studies reporting numeric BREAST-Q scores, and the majority (n=17) using non-validated numerical rating scales to assess outcomes. Reported aesthetic outcomes and PROMs were generally favourable across the included studies. Moreover, amongst comparative studies evaluating AFG-containing protocols against non-AFG protocols (n=6), PROMs and aesthetic outcomes were generally more favourable in the former. In studies where pre-operative scores were also reported (n=6), improvements of 19.0-32.0% in aesthetic ratings, as well as in pain and post-operative satisfaction/psychosocial well-being ratings using the BREAST-Q instrument were observed. Cyst formation rates were generally low, with a weighted mean incidence of 5.4% reported across 7 studies. AFG use is associated with generally favourable quality of life and aesthetic outcomes amongst irradiated patients. However, the substantial heterogeneity of reported outcomes remains a limiting factor and demonstrates that there is a need for research to use standardised and validated PROMs.
SN - 2227-684X
SN - 2227-8575
ER -