Radiotherapy in the setting of breast reconstruction: Types, techniques, and timing Journal Article

Authors: Ho, A. Y.; Hu, Z. I.; Mehrara, B. J.; Wilkins, E. G.
Article Title: Radiotherapy in the setting of breast reconstruction: Types, techniques, and timing
Abstract: As the use of breast reconstruction and postmastectomy radiotherapy (PMRT) has increased over the past decade, the typical approach to integrating radiotherapy with breast reconstruction has provoked intense controversy in the management of breast cancer. PMRT can lead to an increased frequency of complications in the reconstructed breast. Conversely, the reconstructed breast can increase the complexity of radiotherapy delivery. How to minimise the frequency of complications without compromising oncological or cosmetic outcomes of the reconstructed breast is an important shared multidisciplinary goal for oncologists and their patients. Several questions remain, however, regarding the type of reconstruction that should be used with PMRT, when reconstruction should be done relative to PMRT and whether radiotherapy treatment should be directed towards the tissue expander or the implant for women who opt for a two-stage expander–implant reconstruction. Following advances in the planning of radiotherapy treatment, new questions about the application of these technologies in the setting of breast reconstruction have arisen. In this Review, we address these questions by reviewing contemporary evidence on the optimal integration of radiotherapy and breast reconstruction in the management of breast cancer. © 2017 Elsevier Ltd
Keywords: adult; treatment outcome; middle aged; patient satisfaction; surgical technique; review; intensity modulated radiation therapy; treatment planning; pathophysiology; cancer radiotherapy; radiation dose; radiotherapy, adjuvant; medical decision making; quality of life; breast cancer; mastectomy; radiation injury; breast neoplasms; breast reconstruction; mammaplasty; time factors; risk assessment; radiation dosage; postoperative complication; postoperative complications; radiation dose fractionation; breast tumor; therapy delay; esthetics; graft survival; breast implants; adjuvant radiotherapy; technology; breast augmentation; recurrence free survival; breast implantation; early intervention; time factor; oncologist; postmastectomy radiotherapy; procedures; breast implant; humans; prognosis; human; female; priority journal
Journal Title: Lancet Oncology
Volume: 18
Issue: 12
ISSN: 1470-2045
Publisher: Elsevier Science, Inc.  
Date Published: 2017-12-01
Start Page: e742
End Page: e753
Language: English
DOI: 10.1016/s1470-2045(17)30617-4
PUBMED: 29208440
PROVIDER: scopus
Notes: Review -- Export Date: 2 January 2018 -- Source: Scopus
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MSK Authors
  1. Babak Mehrara
    265 Mehrara