Immediate Breast Reconstruction with Abdominal Free Flap and Adjuvant Radiotherapy: Evaluation of Quality of Life and Outcomes

Abstract

Therapeutic, III.

DIEP Flap Breast Reconstruction Complication Rate in Previously Irradiated Internal Mammary Nodes

“…Numerous studies have tried to examine the implications of radiotherapy on various autologous breast reconstructions, 28,29 to determine the best timing for breast reconstruction, before or after adjuvant radiotherapy. [15][16][17][18][19][20][21][22][23][24][25] Despite the growing use of regional irradiation, however, there still are no data on the effect of radiation exposure on surgical outcome in this setting.…”

“…[15][16][17][18][19] However, several works have shown a significant advantage to delayed reconstruction, including less flap fibrosis and less need for revision surgeries. 20,21 Although immediate autologous reconstruction in patients requiring PMRT has recently been revisited, 22,23 the common practice in this population continues to be delaying reconstruction until mastectomy and PMRT have been completed. 24,25 These changes in oncologic and reconstructive practice have led to a growing number of patients receiving RNI prior to DIEP flap reconstruction (►Fig.…”

Neoadjuvant Radiotherapy: Changing the Treatment Sequence to Allow Immediate Free Autologous Breast Reconstruction

“…13,15,16 The deleterious effects of PMRT are, however, somewhat controversial, with other studies reporting no significant difference in complication and patient satisfaction rates between irradiated and nonirradiated flaps. 17,18 Kronowtiz et al 19,20 described the "delayed-immediate" breast reconstruction technique in 2004. This involves the placement of a temporary tissue expander at the time of mastectomy, which is later removed and replaced with autologous reconstruction after adjuvant radiotherapy.…”

International multidisciplinary expert panel consensus on breast reconstruction and radiotherapy

“…The generic reference to ‘breast reconstruction’ was intended to capture all articles addressing the type and timing of breast reconstruction. Two authors independently reviewed abstracts of all studies published between 1985 and 2014, and the full texts of those studies published in 2015–2017. Levels of clinical evidence (LoE) were evaluated for each publication and scored from I to V by employing Oxford criteria.…”