A Call to Bridge the Divide in Breast Reconstruction Research: A Systematic Review

Purpose: Breast reconstruction is an important component of comprehensive breast cancer care. Although reconstructive plans require multidisciplinary clinical-decision making, research in cross-discipline collaborations is often limited. This study aims to evaluate multidisciplinary involvement in breast reconstruction outcomes research.

Methods: A systematic review of breast reconstruction literature published from 2000-2019 using Ovid MEDLINE, Ovid EMBASE, and PubMed databases was conducted. English language articles published in North America or Europe with a n ≥ 12 non-pediatric patients were included. Articles concerning procedures not performed in the context of breast cancer care or articles that did not evaluate at least one outcome, diagnostic test, or risk factor were excluded. Authors’ affiliations were used to define multidisciplinary involvement. Quality of research was evaluated using level of evidence, journal impact factor (IF), and altmetrics.

Results: Of the 1679 articles screened, 784 met the stated eligibility criteria. Only half (50.6%) of these articles involved an author outside the discipline of plastic surgery. Compared to non-multidisciplinary studies, multidisciplinary studies were more likely to be designated a higher level of evidence (I or II) (p<0.001), published in journals with higher IF (p<0.05), have higher usage (p=0.03), and mentions (p=0.02). There was no difference in citations, captures, and social media posts (p>0.05).

Conclusion: Breast reconstruction outcomes research often fails to offer author collaborations from non-plastic surgery disciplines. Multi-disciplinary involvement in breast cancer care research is strongly recommended to improve the quality and impact of clinical studies in breast reconstruction.

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