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Radiation Therapy Following Postmastectomy Reconstruction: A Systematic Review

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

A lack of consistent data are available about optimizing cosmetic outcomes, reducing potential treatment-related toxicities, and defining important prognostic factors for women undergoing postmastectomy radiation therapy (PMRT) following breast reconstruction. A Medline search was conducted to summarize the latest data on the topic with a focus on both autologous and tissue expander/implant (E/I) reconstructions. Autologous tissue reconstructions (ATR) represent less than 20 % of all breast reconstructions and include several techniques. A multitude of small studies have suggested that ATR is associated with improved cosmetic outcomes and similar rates of complications compared with E/I reconstructions. With regards to ATRs, the addition of PMRT has been suggested but not definitively associated with a decrement in cosmetic outcome compared with patients not receiving radiation. Expander/implant-based reconstruction appears to be the most common form of breast reconstruction with large, prospective, and retrospective series demonstrating that 20–30 % of patients may require some type of revision/replacement with long-term follow-up based on large series from Memorial Sloan Kettering Cancer Center and the Cleveland Clinic. Whereas PMRT and the addition of regional irradiation has been traditionally associated with increased complications and worse outcomes with E/I reconstruction, recent data suggest that no difference in perioperative complications exists in patients receiving PMRT using modern techniques.

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Authors and Affiliations

  1. Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO, USA

    Chirag Shah MD

  2. Department of Surgery, Digestive Disease Institute, Cleveland Clinic Foundation, Cleveland, OH, USA

    Neilendu Kundu MD

  3. Department of Radiation Oncology, Massey Cancer Center, Virginia Commonwealth University, Richmond, VA, USA

    Douglas Arthur MD

  4. Michigan HealthCare Professionals/21st Century Oncology, Farmington Hills, MI, USA

    Frank Vicini MD, FACR

Authors
  1. Chirag Shah MD
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  2. Neilendu Kundu MD
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  3. Douglas Arthur MD
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  4. Frank Vicini MD, FACR
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Correspondence to Chirag Shah MD.

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Shah, C., Kundu, N., Arthur, D. et al. Radiation Therapy Following Postmastectomy Reconstruction: A Systematic Review. Ann Surg Oncol 20, 1313–1322 (2013). https://doi.org/10.1245/s10434-012-2689-4

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  • DOI: https://doi.org/10.1245/s10434-012-2689-4

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