Onkologie. 2023:17(2):113-118 | DOI: 10.36290/xon.2023.023

Breast reconstruction and radiotherapy

Igor Sirák1, Aleš Fibír2, Igor Slaninka2, Adam Paulík1, Iveta Kolářová1, Petr Motyčka3, Jakub Grepl1, Petr Paluska1, Milan Vošmik1
1 Klinika onkologie a radioterapie, Fakultní nemocnice Hradec Králové
2 Oddělení plastické a estetické chirurgie a léčby popálenin, Fakultní nemocnice Hradec Králové
3 Chirurgická klinika, Fakultní nemocnice Hradec Králové

Breast-conserving surgical treatment combined with perioperative systemic therapy and postoperative radiotherapy is the standard treatment for early-stage breast carcinoma. Mastectomy continues to be performed in patients in whom breast-conserving surgery cannot be recommended for therapeutic or cosmetic reasons. They often have locally or regionally advanced disease in which mastectomy is virtually always followed by adjuvant radiotherapy. Breast reconstruction following mastectomy is increasingly encountered, and this trend will continue to grow in the future. With advances in medicine, there has been progress in both the surgical procedures used in reconstruction and the technical aspects of radiotherapy. The issue of correct combination and timing of reconstruction and adjuvant radiotherapy continues to raise numerous questions which the present review article attempts to address.

Keywords: breast carcinoma, reconstruction, radiotherapy.

Accepted: April 26, 2023; Published: April 27, 2023  Show citation

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Sirák I, Fibír A, Slaninka I, Paulík A, Kolářová I, Motyčka P, et al.. Breast reconstruction and radiotherapy. Onkologie. 2023;17(2):113-118. doi: 10.36290/xon.2023.023.
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References

  1. Overgaard M, Hansen PS, Overgaard J, et al. For the Danish Breast Cancer Cooperative Group 82b trial. Postoperative radiotherapy in high-risk premenopausal women with breast cancer who receive adjuvant chemotherapy. N Engl J Med. 1997;337:949-955. Go to original source... Go to PubMed...
  2. Overgaard M, Jensen MB, Overgaard J, et al. Postoperative radiotherapy in high-risk postmenopausal breast-cancer patients given adjuvant tamoxifen: Danish Breast Cancer Cooperative Group DBCG 82c randomised trial. Lancet. 1999;353:1641-1648. Go to original source... Go to PubMed...
  3. Ragaz J, Jackson SM, Le N, et al. Adjuvant radiotherapy and chemotherapy in node-positive premenopausal women with breast cancer. N Engl J Med. 1997;337:956-962. Go to original source... Go to PubMed...
  4. Taghian A, Jeong JH, Mamounas E, et al. Patterns of locoregional failure in patients with operable breast cancer treated by mastectomy and adjuvant chemotherapy with or without tamoxifen and without radiotherapy: results from five National Surgical Adjuvant Breast and Bowel Project randomized clinical trials. J Clin Oncol. 2004;22:4247-4254. Go to original source... Go to PubMed...
  5. Nahabedian MY, Tsangaris T, Momen B, et al. Manson. Infectious complications following breast reconstruction with expanders and implants. Plast Reconstr Surg. 2003;112:467-476. Go to original source... Go to PubMed...
  6. Christante D, Pommier SJ, Diggs BS, et al. Using complications associated with postmastectomy radiation and immediate breast reconstruction to improve surgical decision making. Arch Surg. 2010;145:873-878. Go to original source... Go to PubMed...
  7. Berry T, Brooks S, Sydow N, et al. Complication rates of radiation on tissue expander and autologous tissue breast reconstruction. Ann Surg Oncol. 2010;17(suppl 3):202-210. Go to original source... Go to PubMed...
  8. Chang DW, Barnea Y, Robb GL. Effects of an autologous flap combined with an implant for breast reconstruction: an evaluation of 1000 consecutive reconstructions of previously irradiated breasts. Plast Reconstr Surg. 2008;122:356-362. Go to original source... Go to PubMed...
  9. Ascherman JA, Hanasono MH, Newman MI, et al. Implant reconstruction in breast cancer patients treated with radiation therapy. Plast Reconstr Surg. 2006;117:359-365. Go to original source... Go to PubMed...
  10. Yanko-Arzi R, Cohen MJ, Braunstein R, et al. Breast reconstruction: complication rate and tissue expander type. Aesthetic Plast Surg. 2009;33489-496. Go to original source... Go to PubMed...
  11. Boneti C, Yuen J, Santiago C, et al. Oncologic safety of nipple skin-sparing or total skin-sparing mastectomies with immediate reconstruction. J Am Coll Surg. 2011;212:686-695. Go to original source... Go to PubMed...
  12. Atisha D, Alderman AK, Lowery JC, et al. Prospective analysis of long-term psychosocial outcomes in breast reconstruction: two-year postoperative results from the Michigan Breast Reconstruction Outcomes Study. Ann Surg. 2008;247:1019-1028. Go to original source... Go to PubMed...
  13. Jagsi R, Jiang J, Momoh AO, et al. Trends and variation in use of breast reconstruction in patients with breast cancer undergoing mastectomy in the United States. J Clin Oncol. 2014;32:919-926. Go to original source... Go to PubMed...
  14. Clemens MW, Kronowitz SJ. Current perspectives on radiation therapy in autologous and prosthetic breast reconstruction. Gland Surg. 2015;4:222-231. Go to PubMed...
  15. Al-Ghazal SK, Sully L, Fallowfield L, The psychological impact of immediate rather than delayed breast reconstruction. Eur J Surg Oncol. 2000;26:17-19. Go to original source... Go to PubMed...
  16. Zhong T, Hu J, Bagher S, et al. A comparison of psychological response, body image, sexuality, and quality of life between immediate and delayed autologous tissue breast reconstruction: a prospective long-term outcome study. Plast Reconstr Surg. 2016;138:772-780. Go to original source... Go to PubMed...
  17. Clough KB, O'Donoghue JM, Fitoussi AD, et al. Prospective evaluation of late cosmetic results following breast reconstruction: I. Implant reconstruction. Plast Reconstr Surg. 2001;107:1702-1709. Go to original source... Go to PubMed...
  18. Clough KB, O'Donoghue JM, Fitoussi AD. Prospective evaluation of late cosmetic results following breast reconstruction: II. Tram flap reconstruction. Plast Reconstr Surg. 2001;107:1710-1716. Go to original source... Go to PubMed...
  19. Pirro O, Mestak O, Vindigni V, et al. Comparison of patient-reported outcomes after implant versus autologous tissue breast reconstruction using the BREAST-Q. Plast Reconstr Surg Glob Open. 2017;5:e1217. Go to original source... Go to PubMed...
  20. Sgarzani R, Negosanti L, Morselli PG, et al. Cipriani Patient satisfaction and quality of life in DIEAP flap versus implant breast reconstruction. Surg Res Pract. 2015;405163. Go to original source... Go to PubMed...
  21. Roostaeian J, Crisera C. Current options in breast reconstruction with or without radiotherapy. Curr Opin Obstet Gynecol. 2011;23:44-50. Go to original source... Go to PubMed...
  22. Carlson GW, Page AL, Peters K, et al. Effects of radiation therapy on pedicled transverse rectus abdominis myocutaneous flap breast reconstruction. Ann Plast Surg. 2008;60:568-572. Go to original source... Go to PubMed...
  23. Garvey PB, Clemens MW, Hoy AE, et al. Muscle-sparing TRAM flap does not protect breast reconstruction from postmastectomy radiation damage compared with the DIEP flap. Plast Reconstr Surg. 2014;133:223-233. Go to original source... Go to PubMed...
  24. Krueger EA, Wilkins EG, Strawderman M, et al. Complications and patient satisfaction following expander/implant breast reconstruction with and without radiotherapy. Int J Radiat Oncol Biol Phys. 2001;49:713-721. Go to original source... Go to PubMed...
  25. McCarthy CM, Pusic AL, Disa JJ, et al. Unilateral postoperative chest wall radiotherapy in bilateral tissue expander/implant reconstruction patients: a prospective outcomes analysis. Plast Reconstr Surg. 2005;116:1642-1647. Go to original source... Go to PubMed...
  26. Cordeiro PG, Albornoz CR, McCormick B, et al. What is the optimum timing of postmastectomy radiotherapy in two-stage prosthetic reconstruction: radiation to the tissue expander or permanent implant? Plast Reconstr Surg. 2015;135:1509-1517. Go to original source... Go to PubMed...
  27. Anderson PR, Freedman G, Nicolaou N, et al. Postmastectomy chest wall radiation to a temporary tissue expander or permanent breast implant - is there a difference in complication rates? Int J Radiat Oncol Biol Phys. 2009;74:81-85. Go to original source... Go to PubMed...
  28. Santosa KB, Chen X, Qi J, et al. Postmastectomy radiation therapy and two-stage implant-based breast reconstruction: is there a better time to irradiate? Plast Reconstr Surg. 2016;138:761-769. Go to original source... Go to PubMed...
  29. Collier P, Williams J, Edhayan G, et al. The effect of timing of postmastectomy radiation on implant-based breast reconstruction: a retrospective comparison of complication outcomes. Am J Surg. 2014;207:408-411. Go to original source... Go to PubMed...
  30. Yan C, Fischer JP, Freedman GM, et al. The timing of breast irradiation in two-stage expander/implant breast reconstruction. Breast J. 2016;22:322-329. Go to original source... Go to PubMed...
  31. Lee KT, Mun GH. Optimal sequencing of postmastectomy radiotherapy and two stages of prosthetic reconstruction: a meta-analysis. Ann Surg Oncol. 2017;24:1262-1268. Go to original source... Go to PubMed...
  32. Peled AW, Foster RD, Esserman LJ, et al. Fowble. Increasing the time to expander-implant exchange after postmastectomy radiation therapy reduces expander-implant failure. Plast Reconstr Surg. 2012;130:503-509. Go to original source... Go to PubMed...
  33. Cordeiro PG, Albornoz CR, McCormick B, et al. The impact of postmastectomy radiotherapy on two-stage implant breast reconstruction: an analysis of long-term surgical outcomes, aesthetic results, and satisfaction over 13 years. Plast Reconstr Surg. 2014;134:588-595. Go to original source... Go to PubMed...
  34. Momoh AO, Colakoglu S, de Blacam C, et al. Delayed autologous breast reconstruction after postmastectomy radiation therapy: is there an optimal time? Ann Plast Surg. 2012;69:14-18. Go to original source... Go to PubMed...
  35. Baumann DP, Crosby MA, Selber JC, et al. Optimal timing of delayed free lower abdominal flap breast reconstruction after postmastectomy radiation therapy. Plast Reconstr Surg. 2011;127:1100-1106. Go to original source...
  36. Kaidar-Person O, Offersen BV, Poortmans P. Should risk-adapted delineation considered de-escalation of therapy? The ESTRO-ACROP radiation therapy guidelines after implant-based immediate reconstruction for early stage breast cancer. Radiother Oncol 2019;141:327-327. Go to original source... Go to PubMed...
  37. Kaidar-Person O, Nissen HD, ES Yates, et al. Postmastectomy Radiation Therapy Planning After Immediate Implant-based Reconstruction Using the European Society for Radiotherapy and Oncology-Advisory Committee in Radiation Oncology Practice Consensus Guidelines for Target Volume Delineation. Clin Oncol. 2021;33:20-29. Go to original source... Go to PubMed...
  38. Chung E, Marsh RB, Griffith KA, et al. Quantifying dose to the reconstructed breast: can we adequately treat? Med Dosim. 2013;38:55-59. Go to original source... Go to PubMed...
  39. Ohri N, Cordeiro PG, Keam J, et al. Quantifying the impact of immediate reconstruction in postmastectomy radiation: a large, dose-volume histogram-based analysis. Int J Radiat Oncol Biol Phys. 2012;84:e153-e159. Go to original source... Go to PubMed...
  40. AY Ho, ZI Hu, BJ Mehrara, et al. Radiotherapy in the setting of breast reconstruction: types, techniques, and timing. Lancet. 2017;18:742-753. Go to original source... Go to PubMed...
  41. Seung YC, Jee SC, Kyung HS, et al. Impact of radiation dose on complications among women with breast cancer who underwent breast reconstruction and post-mastectomy radiotherapy: A multi-institutional validation study. Tjhe Breast. 2021:56:7-13. Go to original source... Go to PubMed...




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