Current approaches to breast reconstruction: A scoping review of outcomes and factors influencing core outcome sets

Breast cancer is the most common malignancy among women worldwide. Surgery is part of the standard treatment for most new breast cancer patients. Surgical options include breast conserving surgery and mastectomy. Breast reconstruction is commonly offered to patients undergoing mastectomy for breast cancer. The aim of this review was to evaluate current approaches to breast reconstruction and factors influencing core outcome sets for breast reconstruction. This review focused to identify keywords pertaining to the review aim such as: "breast reconstruction" AND "breast cancer" AND "outcomes" through Medline. There were 49 relevant manuscripts identified between the July 2018 to July 2023. Additionally, we identified based on the literature review manuscripts on topics of oncological outcomes after breast reconstruction. Preference was given to the sources published in the last five years. Available research indicates that although general quality of life post-reconstruction is comparable across surgical methods, variations exist in postoperative satisfaction, complications, and recovery. Autologous reconstruction is often associated with higher patient satisfaction and well-being across physical, psychosocial, and aesthetic domains compared to implant-based reconstruction. Key risk factors for complications include diabetes, obesity, and smoking, which impact postoperative recovery and readmission rates. Additionally, postmastectomy radiation therapy to breast cancer management increases risks of infection, necrosis, and aesthetic dissatisfaction. However, autologous techniques are somewhat less affected of this risk than implant based techniques. The review underscores the need for enhanced patient education tools and precision-based approaches that address both aesthetic and oncological concerns, setting a foundation for more informed, data-supported decision-making in breast reconstruction.