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We evaluated evidence from all fields involved in care of the breast cancer patient in order to advance a unified recommendation regarding this therapeutic sequence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a MEDLINE and manual reference search to identify studies of PMRT with immediate autologous breast reconstruction. Inclusion criteria required studies to describe patients, flaps, and complication rates. Analyses were based on a random effects model. Surgical and radiation oncology literature was reviewed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eleven retrospective studies of 337 patients with an average follow\u2010up of 18\u201360 months (out of 268 patients) were selected for inclusion. Overall rates of fat necrosis, revisional surgery, volume loss, and fibrosis\/contracture ranged from 16.9% to 35.4%. One out of 260 patients experienced total flap loss. There was an increased probability of fat necrosis in the irradiated breast (OR\u2009=\u20093.13, 95% CI\u2009=\u20091.42\u20136.89, <jats:italic>P<\/jats:italic>\u2009=\u20090.005) among three studies with non\u2010irradiated controls. Five studies evaluated aesthetics with variable outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>There is mixed evidence for the utility of PMRT with immediate autologous abdominal wall breast reconstruction. Further investigation requires prospective studies with collaboration among surgical oncologists, radiation oncologists, and plastic surgeons. <jats:italic>J. Surg. Oncol. 2015 111:251\u2013257<\/jats:italic>. \u00a9 2014 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jso.23804","type":"journal-article","created":{"date-parts":[[2014,10,22]],"date-time":"2014-10-22T20:58:18Z","timestamp":1414011498000},"page":"251-257","source":"Crossref","is-referenced-by-count":36,"title":["Postmastectomy radiation therapy and immediate autologous breast reconstruction: Integrating perspectives from surgical oncology, radiation oncology, and plastic and reconstructive surgery"],"prefix":"10.1002","volume":"111","author":[{"given":"Danielle H.","family":"Rochlin","sequence":"first","affiliation":[{"name":"Department of Plastic and Reconstructive Surgery Johns Hopkins University School of Medicine Baltimore Maryland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ah\u2010Reum","family":"Jeong","sequence":"additional","affiliation":[{"name":"Keck School of Medicine of University of Southern California Los Angeles 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