Post-mastectomy radiation therapy after breast reconstruction: from historic dogmas to practical expert agreements based on a large literature review of surgical and radiation therapy considerations

Yazid Belkacemi; Meena S Moran; Burcu Celet Ozden; Yazan Masannat; Fady Geara; Mohamed Albashir; Nhu Hanh To; Kamel Debbi; Mahmoud El Tamer

doi:10.1016/j.critrevonc.2024.104421

Post-mastectomy radiation therapy after breast reconstruction: from historic dogmas to practical expert agreements based on a large literature review of surgical and radiation therapy considerations

Crit Rev Oncol Hematol. 2024 Aug:200:104421. doi: 10.1016/j.critrevonc.2024.104421. Epub 2024 Jun 12.

Authors

Yazid Belkacemi¹, Meena S Moran², Burcu Celet Ozden³, Yazan Masannat⁴, Fady Geara⁵, Mohamed Albashir⁶, Nhu Hanh To⁷, Kamel Debbi⁷, Mahmoud El Tamer⁸

Affiliations

¹ AP-HP, Department of Radiation Oncology and Henri Mondor Breast Center, Henri Mondor University Hospital. University of Paris Est Creteil (UPEC), France; Institut Mondor de Recherche Biomédicale (IMRB), INSERM U955, i-Biot, UPEC, Créteil, France. Electronic address: [email protected].
² Smilow Cancer Center, Yale University School of Medicine. Department of Therapeutic Radiology, New Haven, CT, USA.
³ Istanbul Breast Clinic, Istanbul, Turkey.
⁴ Broomfield Hospital, Mid and South Essex NHS Trust, England, UK.
⁵ Department of Radiation Oncology, Oncology Institute, Cleveland Clinic Abu Dhabi, United Arab Emirates.
⁶ Levantine Medical Center, Ain Alkhaleej Hospital and Burjeel Royal Hospital, Alain, United Arab Emirates.
⁷ AP-HP, Department of Radiation Oncology and Henri Mondor Breast Center, Henri Mondor University Hospital. University of Paris Est Creteil (UPEC), France; Institut Mondor de Recherche Biomédicale (IMRB), INSERM U955, i-Biot, UPEC, Créteil, France.
⁸ Memorial Sloan Kettering Cancer Center and Weill Medical College at Cornell University, New York, USA.

PMID: 38876160
DOI: 10.1016/j.critrevonc.2024.104421

Abstract

Breast reconstruction (BR) after mastectomy is important to consider for a woman's body image enhancement and psychological well-being. Although post-mastectomy radiation (PMRT) significantly improves the outcome of patients with high-risk breast cancer (BC), PMRT after BR may affect cosmetic outcomes and may compromise the original goal of improving quality of life (QoL). With the lack of practical guidelines, it seems essential to work on a consensus and provide some "expert agreements" to offer patients the best option for PMRT after BR. We report a global "expert agreement" that results from a critical review of the literature on BR and PMRT during the 6th international multidisciplinary breast conference in March 2023.

Keywords: Breast cancer; Breast reconstruction; Cosmesis; DIEP; Flap; Mastectomy; PMRT; Prosthesis; Radiation therapy; Toxicity.

Publication types

Review

MeSH terms

Breast Neoplasms* / radiotherapy
Breast Neoplasms* / surgery
Female
Humans
Mammaplasty*
Mastectomy*
Quality of Life
Radiotherapy, Adjuvant / methods