title: Omentum for Mammary Disorders: A 30-Year Systematic Review.
abstract: OBJECTIVE
  Although the safety of applying omentum to the female breast for total breast reconstruction is controversial, it has recently been used to treat certain mammary disorders as well. A systematic review was therefore conducted to analyze and establish the suitability and safety of applying omentum to the breast.
  
  
  METHODS
  Covereing the interval from January 1984 to December 2013, we performed searches in MEDLINE, Embase, SciELO, and Google-Scholar for original articles describing the applicability of greater omentum to the breast and its clinical complications.
  
  
  RESULTS
  Sixty observational articles with 985 women were chosen. The main clinical indications were total breast reconstruction after mastectomy due to breast cancer (45 studies), radiation damage (23 studies), and congenital Poland syndrome (4 studies). Altogether, 273 complications were identified among the 985 women treated. The most frequent was flap necrosis (26.74 %). The most serious was injury to the digestive system (1.10 %). There was a 35.48 % incidence of local breast cancer recurrence in eight observational studies on oncological risk. Seven of the eight included only women with advanced cancer. One of these studies reported the incidence and relapse time predominantly according to the primary tumor size.
  
  
  CONCLUSIONS
  Although the oncological risk remains unclear, there was a high volume of complications that affected the digestive system. These findings suggest that omentum has well established applicability, but only for total breast reconstruction of huge defects, where muscular/myocutaneous or perforator flaps may be unsuitable.
authors.affiliation: Department of Gynecology and Obstetrics, School of Medical Sciences, State University of Campinas - UNICAMP, Rua Alexander Fleming, 101, Campinas, 13083-881, SP, Brazil, fclarojr@gmail.com.
authors.forename: Francisco
authors.initials: F
authors.lastname: Claro
authors.forename: Luís Otávio Zanatta
authors.initials: LO
authors.lastname: Sarian
authors.forename: Aarão Mendes
authors.initials: AM
authors.lastname: Pinto-Neto
mesh_terms: D001943:Breast Neoplasms / Q000601:surgery*; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects / Q000379:methods*; D008408:Mastectomy; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D064887:Observational Studies as Topic; D009852:Omentum / Q000637:transplantation*; D011045:Poland Syndrome / Q000601:surgery*; D011832:Radiation Injuries / Q000601:surgery*