The Effects of Radiotherapy on the Sequence and Eligibility of Breast Reconstruction: Current Evidence and Controversy.
Andrew R CampbellAlexander J DidierTaha M SheikhSami AnsariDean E WatkinsAlan M FahourySwamroop V NandwaniMohammad RashidPublished in: Cancers (2024)
Immediate breast reconstruction (IBR) following a mastectomy, combined with radiotherapy, presents a multifaceted approach to breast cancer treatment, balancing oncological safety and aesthetic outcomes. IBR, typically involving the use of implants or autologous tissue, aims to restore breast morphology directly after a mastectomy, minimizing the psychological and physical impacts. However, integrating radiotherapy with IBR is complex due to the potential adverse effects on reconstructed tissues. Radiotherapy, essential for reducing local recurrence, can induce fibrosis, capsular contracture, and compromised aesthetic results. This narrative review covers the current trends in the sequencing of breast reconstruction and radiotherapy. We discuss patient selection, timing of radiotherapy, and reconstructive techniques, with special attention paid to quality-of-life outcomes that are increasingly reported in clinical trials. Emerging evidence supports the feasibility of IBR with careful patient selection and tailored therapeutic approaches, although ongoing research is necessary to refine protocols and enhance outcomes. Overall, IBR in the context of radiotherapy remains a promising but intricate treatment modality, requiring a nuanced balance between cancer control and aesthetic restoration.
Keyphrases
- breast reconstruction
- early stage
- locally advanced
- radiation induced
- radiation therapy
- clinical trial
- rectal cancer
- squamous cell carcinoma
- gene expression
- prostate cancer
- randomized controlled trial
- bone marrow
- type diabetes
- risk assessment
- stem cells
- mesenchymal stem cells
- working memory
- cell therapy
- young adults
- weight loss
- open label
- soft tissue
- liver fibrosis
- adverse drug