Annals of Surgical Oncology

, Volume 20, Issue 4, pp 1313–1322 | Cite as

Radiation Therapy Following Postmastectomy Reconstruction: A Systematic Review

  • Chirag Shah
  • Neilendu Kundu
  • Douglas Arthur
  • Frank Vicini
Breast Oncology

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.

Notes

Conflict of interest

None.

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Copyright information

© Society of Surgical Oncology 2012

Authors and Affiliations

  • Chirag Shah
    • 1
  • Neilendu Kundu
    • 2
  • Douglas Arthur
    • 3
  • Frank Vicini
    • 4
  1. 1.Department of Radiation OncologyWashington University School of MedicineSt. LouisUSA
  2. 2.Department of SurgeryDigestive Disease Institute, Cleveland Clinic FoundationClevelandUSA
  3. 3.Department of Radiation OncologyMassey Cancer Center, Virginia Commonwealth UniversityRichmondUSA
  4. 4.Michigan HealthCare Professionals/21st Century OncologyFarmington HillsUSA

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