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Dengsoe et al. Plast Aesthet Res 2024;11:25 Plastic and
DOI: 10.20517/2347-9264.2024.20
Aesthetic Research

Systematic Review Open Access

A systematic review on the effect of immediate
autologous microsurgical breast reconstruction on

the timely initiation of adjuvant therapy

1
1
Ida Bjoernsted Dengsoe , Ajla Sabitovic , Tine Engberg Damsgaard 2
1
Department of Plastic and Reconstructive Surgery, University Hospital of Southern Denmark, Vejle 7100, Denmark.
2
Department of Plastic and Reconstructive Surgery and Department of Regional Health Research, Odense University Hospital,
Odense and University Hospital of Southern Denmark, Vejle and University of Southern Denmark, Vejle 7100, Denmark.
Correspondence to: Dr. Ida Bjoernsted Dengsoe, Department of Plastic and Reconstructive Surgery, University Hospital of
Southern Denmark, Beriderbakken 4, Vejle 7100, Denmark.

How to cite this article: Dengsoe IB, Sabitovic A, Damsgaard TE. A systematic review on the effect of immediate autologous
microsurgical breast reconstruction on the timely initiation of adjuvant therapy. Plast Aesthet Res 2024;11:25. https://dx.doi.org/
10.20517/2347-9264.2024.20

Received: 4 Feb 2024 First Decision: 27 May 2024 Revised: 11 Jun 2024 Accepted: 24 Jun 2024 Published: 28 Jun 2024
Academic Editors: Roberto Cuomo; Marten Basta Copy Editor: Yanbing Bai Production Editor: Yanbing Bai

Abstract
Aim: Postoperative administration of adjuvant therapy is associated with reduced breast cancer recurrence and
mortality. Concerns have been raised that immediate reconstruction may lead to a delay in the administration of
adjuvant therapy with the risk of compromising survival. This systematic review seeks to evaluate and discuss
whether post-mastectomy immediate autologous microsurgical breast reconstruction affects the timely initiation
of adjuvant chemotherapy and radiotherapy.

Methods: PubMed and EMBASE were searched to identify studies assessing the impact of immediate autologous
microsurgical breast reconstruction on the timely initiation of adjuvant therapy.

Results: Seven studies comprising 267 patients treated with immediate autologous microsurgical reconstruction
followed by adjuvant therapy and 2,622 patients treated with mastectomy-only followed by adjuvant therapy were
included in this study. Reconstructed patients started adjuvant therapy later, with a mean difference ranging from 2
to 14 days. Adjuvant therapy was initiated after 4-10 weeks in most cases - regardless of reconstruction or not -
and only few examples of delays of more than 12 weeks were recorded. Major postoperative complications were
found to be associated with delay in the initiation of adjuvant therapy.

© The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, sharing,
adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and
indicate if changes were made.

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