Breast Radiotherapy after Oncoplastic Surgery—A Multidisciplinary Approach

Metz, Gabrielle; Snook, Kylie; Sood, Shilpa; Baron‐Hay, Sally; Spillane, Andrew J.; Lamoury, Gillian; Carroll, Susan

doi:10.3390/cancers14071685

Cited by 6 publications

(4 citation statements)

References 138 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Therefore, in all patients, but specifically in patients with an indication for boost therapy, the benefits of OPBCS should be discussed multidisciplinaryly, keeping both oncological and aesthetic outcomes in mind. Metz et al ( 57 ) reported on some crucial multidisciplinary recommendations when considering OPBCS:…”

Section: Radiotherapy After Opbcsmentioning

confidence: 99%

A clinical perspective on oncoplastic breast conserving surgery

Heeling,

van Hemert,

Vrancken Peeters

2023

Transl Breast Cancer Res

View full text Add to dashboard Cite

Breast conserving surgery (BCS) plus radiation treatment is the favored alternative for mastectomy in patients with breast cancer. To allow for breast conservation in patients with large invasive tumors and poor response to neoadjuvant systemic treatment (NST) or patients with extensive ductal carcinoma in situ (DCIS), oncoplastic breast conserving surgery (OPBCS) techniques are introduced. OPBCS allows for breast conservation in a selective group of breast cancer patients who initially would have been treated with mastectomy due to the unfavorable tumor-to-breast ratio. With OPBCS, the oncological tumor excision is combined with plastic surgical breast conservation techniques without compromising oncological safety and maintaining aesthetic outcomes by preserving the shape of the breast. OPBCS should however not be applied to all breast cancer patients and the selection of patients who benefit from OPBCS and the timing of OPBCS are best discussed in a multidisciplinary team (MDT). Caution is required in patients with higher risk of positive margins [e.g., multifocal breast cancer, invasive lobular carcinoma (ILC), larger tumors and DCIS]. In these patients, delayed OPBCS is recommended to facilitate re-excision and maintain excellent breast conserving rates. Despite proven benefits in selected patients, the increase in the adoption of OPBCS is relatively low. This article provides a clinical perspective on OPBCS.

show abstract

Section: Radiotherapy After Opbcsmentioning

confidence: 99%

A clinical perspective on oncoplastic breast conserving surgery

Heeling,

van Hemert,

Vrancken Peeters

2023

Transl Breast Cancer Res

View full text Add to dashboard Cite

show abstract

“…Regarding breast cancer treatment, tumor characteristics, the type of surgical procedure, and chemo and RT can influence the breast cancer mortality ratio ( 3 ). Hence, the indication of RT after a total mastectomy in patients with positive lymph nodes decreases breast cancer mortality and distant/locoregional recurrence, contrary to patients with negative nodes ( 19 , 20 ).…”

Section: Basic Concepts In Breast Reconstructionmentioning

confidence: 99%

“…In the United States, 1 in 8 women will be diagnosed with invasive breast cancer, with an estimated 287,850,000 new cases diagnosed in 2022 ( 2 ). Surgery, radiation, and systemic treatment remain the crucial components of treatment, with approximately 8 out of 10 patients receiving ionizing radiation at some point ( 3 ). Additionally, breast reconstruction (BR) after mastectomy has improved patients’ satisfaction and well-being, reduced overall treatment costs, and provided better aesthetic results ( 3 , 4 ).…”

Section: Introductionmentioning

confidence: 99%

“…Surgery, radiation, and systemic treatment remain the crucial components of treatment, with approximately 8 out of 10 patients receiving ionizing radiation at some point ( 3 ). Additionally, breast reconstruction (BR) after mastectomy has improved patients’ satisfaction and well-being, reduced overall treatment costs, and provided better aesthetic results ( 3 , 4 ). Therefore, to ensure the best patient recovery, a perfect integration between these two procedures is essential.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Technical consideration for breast reconstruction in patients requiring neoadjuvant or adjuvant radiotherapy: a narrative review

Maita,

Torres-Guzman,

Avila

et al. 2023

Ann Transl Med

View full text Add to dashboard Cite

Background and Objective Surgical considerations for breast reconstruction (BR) in patients requiring neoadjuvant radiotherapy (NART) or adjuvant radiotherapy (ART) cannot be understated. The management of irradiated tissue leads surgeons to face several challenges. Therefore, it is essential to comprehensively understand the proper patient selection and preoperative planning to ensure the best outcomes and minimize the risk of complications. This narrative review aims to provide an update and summary of the most important technical considerations every breast surgeon must contemplate reconstructing the irradiated breast. Methods The search strategy was performed on January 10th, 2023. The PubMed, Embase, Cochrane Library, and Web of Science databases were queried to capture all publications regarding surgical considerations in BR of patients undergoing NART and ART. Key Content and Findings This review shows that the effects of radiotherapy (RT) on BR are still being studied. RT represents an essential factor for overall patient survival, and its use is increasing. However, the range of RT treatments across different cancer centers complicates the creation of a single treatment protocol. BR improves women’s quality of life, so finding the proper integration of BR and RT is essential. When deciding on the reconstructive method, there are several factors to consider, such as the patient’s body characteristics, tumor stage, RT protocol, and chemotherapy. To achieve the best surgical results and the most satisfied patient, using less aggressive and safer RT methods in the treatment sequence is recommended. Conclusions The timing of the radiation will influence the selection of the best reconstructive methods to be employed in the breast cancer patient. However, there is clear evidence of preference for immediate autologous-based BR in cases due to the low rate of complications in the long term. But patient individualization is the key. Therefore, the benefits and risks of immediate versus delayed and autologous versus implant-based reconstruction must be weighed in every single case.

show abstract