TY - JOUR

T1 - A multidisciplinary approach for autologous breast reconstruction

T2 - A narrative (re)view for better management

AU - Kaidar-Person, Orit

AU - Hermann, Naama

AU - Poortmans, Philip

AU - Offersen, Birgitte V.

AU - Boersma, Liesbeth J.

AU - de Ruysscher, Dirk

AU - Tramm, Trine

AU - Kühn, Thorsten

AU - Engberg Damsgaard, Tine

AU - Gentilini, Oreste

AU - Maarse, Wies

AU - Sklair-Levi, Miri

AU - Mátrai, Zoltán

N1 - Publisher Copyright: © 2021 Elsevier B.V.

PY - 2021

Y1 - 2021

N2 - Breast reconstruction and oncoplastic surgery have become an important part of breast cancer care. The use of autologous breast reconstruction (ABR) has evolved significantly with advances in microsurgery, aiming to reduce donor site complications and improve cosmesis. For years, immediate-ABR was considered a contraindication if postmastectomy irradiation (PMRT) was planned. As a result of de-escalation of axillary surgery the indication of PMRT are increasing along-side with observations that PMRT in the setting of ABR is not contraindicated. Surgical techniques may result in different amount and areas of breast residual glandular tissue and patient selection is important to reduce potential residual disease. Meticulus radiation planning is important to potentially reduce complications without compromising oncologic outcomes. Surgical techniques change constantly in aim to improve aesthetic results but should most importantly maintain priority to the oncological indications. By multidisciplinary team work with a comprehensive understanding of each discipline, we can preserve the accomplishments of breast surgery in the setting of PMRT, without compromising disease control.

AB - Breast reconstruction and oncoplastic surgery have become an important part of breast cancer care. The use of autologous breast reconstruction (ABR) has evolved significantly with advances in microsurgery, aiming to reduce donor site complications and improve cosmesis. For years, immediate-ABR was considered a contraindication if postmastectomy irradiation (PMRT) was planned. As a result of de-escalation of axillary surgery the indication of PMRT are increasing along-side with observations that PMRT in the setting of ABR is not contraindicated. Surgical techniques may result in different amount and areas of breast residual glandular tissue and patient selection is important to reduce potential residual disease. Meticulus radiation planning is important to potentially reduce complications without compromising oncologic outcomes. Surgical techniques change constantly in aim to improve aesthetic results but should most importantly maintain priority to the oncological indications. By multidisciplinary team work with a comprehensive understanding of each discipline, we can preserve the accomplishments of breast surgery in the setting of PMRT, without compromising disease control.

KW - Autologous

KW - Breast cancer

KW - Radiation therapy

KW - Reconstruction

U2 - 10.1016/j.radonc.2021.01.036

DO - 10.1016/j.radonc.2021.01.036

M3 - Review

C2 - 33582192

AN - SCOPUS:85101406390

VL - 157

SP - 263

EP - 271

JO - Radiotherapy & Oncology

JF - Radiotherapy & Oncology

SN - 0167-8140

ER -