Assessing the Quality of Breast Reconstruction Outcomes Reporting: A 5-Year Scoping Review

Outcomes reporting is essential to advancing health care quality in plastic surgery and aligns closely with patient satisfaction. At present, there is no widely used set of standards for breast reconstruction reporting in the literature. This study aimed to define how breast reconstruction outcomes are characterized in the literature and identify opportunities to improve consistency across studies.

All articles published between 2015 and 2021 in Plastic and Reconstructive Surgery and Annals of Plastic Surgery were screened for original articles that pertained to breast reconstruction. Included articles were evaluated using existing outcomes reporting criteria for breast reconstruction that were adapted from general surgery literature.

Of 833 breast reconstruction articles reviewed, 192 met inclusion criteria. Approximately one-half of the articles ( n = 87 [45.38%]) pertained to autologous breast reconstruction, 127 (66%) pertained to prosthetic breast reconstruction, and 31 (16.15%) included both procedures. Less than one-fifth of studies ( n = 53 [27.42%]) defined at least half of the complications in their study. Less than one-third included at least half of the suggested procedure-specific complications ( n = 53 [27.42%]), used severity grades ( n = 46 [24.19%]), or considered risk factors in analyses ( n = 64 [33.33%]). Infection was the most reported complication ( n = 120 [62.71%]), and 18 distinct definitions were used. Outcomes reporting criteria assessment revealed the average number of criteria met was 3.3 of a possible 10.

This study found significant gaps in outcomes reporting with regard to study design, complications included, and definitions used. There was little improvement in outcomes reporting from 2015 to 2021 compared with the period from 2000 to 2014. This study supports the need for outcomes reporting standards in breast reconstruction to improve study generalizability and quality.