International multidisciplinary expert panel consensus on breast reconstruction and radiotherapy

Nava, Maurizio; Benson, John R.; Audretsch, Werner; Blondeel, Phillip; Catanuto, Giuseppe; Clemens, Mark W.; Cordeiro, Peter G.; Vita, Roy De; Hammond, Dennis C.; Jassem, Jacek; Lozza, Laura; Orecchia, Roberto; Pusic, Andrea L.; Rancati, Alberto; Rezai, Mahdi; Scaperrotta, Gianfranco; Spanò, Andrea; Winters, Zoë; Rocco, Nicola

doi:10.1002/bjs.11256

Cited by 35 publications

(37 citation statements)

References 147 publications

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“…Of them, 168 publications were found duplicated and 7205 did not meet the selection criteria. A total of 59 documents (43 CPGs [ [26] , [27] , [28] , [29] , [30] , [31] , [32] , [33] , [34] , [35] , [36] , [37] , [38] , [39] , [40] , [41] , [42] , [43] , [44] , [45] , [46] , [47] , [48] , [49] , [50] , [51] , [52] , [53] , [54] , [55] , [56] , [57] , [58] , [59] , [60] , [61] , [62] , [63] , [64] , [65] , [66] , [67] , [68] ] and 16 CSs 42–57 [ [69] , [70] , [71] , [72] , [73] , [74] , [75] , [76] , [77] , [78] , [79] , [80] , [81] , [82] , [83] , [84] ]) were identified for final evaluation ( Table 1 ). The flow diagram detailing the study selection process is provided in Fig.…”

Section: Resultsmentioning

confidence: 99%

Quality and reporting of clinical guidelines for breast cancer treatment: A systematic review

Maes‐Carballo

Mignini²,

Martín-Díaz³

et al. 2020

The Breast

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Background High-quality, well-reported clinical practice guidelines (CPGs) and consensus statements (CSs) underpinned by systematic reviews are needed. We appraised the quality and reporting of CPGs and CSs for breast cancer (BC) treatment. Methods Following protocol registration (Prospero n o : CRD42020164801), CPGs and CSs on BC treatment were identiﬁed, without language restrictions, through a systematic search of bibliographic databases (MEDLINE, EMBASE, Web of Science, Scopus, CDSR) and online sources (12 guideline databases and 51 professional society websites) from January 2017 to June 2020. Data were extracted in duplicate assessing overall quality using AGREE II (% of maximum score) and reporting compliance using RIGHT (% of total 35 items); reviewer agreement was 98% and 96% respectively. Results There were 59 relevant guidance documents (43 CPGs, 16 CSs), of which 20 used systematic reviews for evidence synthesis. The median overall quality was 54.0% (IQR 35.9–74.3) and the median overall reporting compliance was 60.9% (IQR 44.5–84.4). The correlation between quality and reporting was 0.9. Compared to CSs, CPGs had better quality (55.4% vs 44.2%; p = 0.032) and reporting (67.18% vs 44.5%; p = 0.005). Compared to subjective methods of evidence analysis, guidance documents that used systematic reviews had better quality (76.3% vs 51.4%; p = 0.001) and reporting (87.1% vs 59.4%; p = 0.001). Conclusion The quality and reporting of CPGs and CSs in BC treatment were moderately strong. Systematic reviews should be used to improve the quality and reporting of CPGs and CSs.

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Section: Resultsmentioning

confidence: 99%

Quality and reporting of clinical guidelines for breast cancer treatment: A systematic review

Maes‐Carballo

Mignini²,

Martín-Díaz³

et al. 2020

The Breast

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“…About 40% of all breast cancer patients undergo breast reconstruction after mastectomy or BCS, and the overall rate of breast reconstruction has been increasing (25). Breast reconstruction can be challenging when integrating with postmastectomy or postlumpectomy RT, which may compromise the skin and underlying tissue due to radiation-induced fibrosis (26,27). Little is known, however, about the effects of hypofractionated RT on reconstructed breast following mastectomy or BCS.…”

Section: Discussionmentioning

confidence: 99%

Hypofractionated versus conventional fractionated radiotherapy for breast cancer in patients with reconstructed breast: Toxicity analysis

et al. 2021

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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“…Evidence suggesting oncological benefits of postmastectomy radiotherapy in patients with one to three positive lymph nodes means that many more patients are now offered treatment. Radiotherapy has been shown to have an adverse impact on both clinical and patient‐reported outcomes of immediate breast reconstruction, particularly with implants. Despite recent updated national guidance, many surgeons would not offer immediate reconstruction if postmastectomy radiotherapy is likely to be required.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic mammaplasty is a safe and effective alternative to mastectomy with or without immediate breast reconstruction

Potter

Trickey

Rattay

et al. 2020

British Journal of Surgery

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Background: Therapeutic mammaplasty (TM) may be an alternative to mastectomy, but few well designed studies have evaluated the success of this approach or compared the short-term outcomes of TM with mastectomy with or without immediate breast reconstruction (IBR). Data from the national iBRA-2 and TeaM studies were combined to compare the safety and short-term outcomes of TM and mastectomy with or without IBR. Methods:The subgroup of patients in the TeaM study who underwent TM to avoid mastectomy were identified, and data on demographics, complications, oncology and adjuvant treatment were compared with those of patients undergoing mastectomy with or without IBR in the iBRA-2 study. The primary outcome was the percentage of successful breast-conserving procedures in the TM group. Secondary outcomes included postoperative complications and time to adjuvant therapy.Results: A total of 2916 patients (TM 376; mastectomy 1532; mastectomy and IBR 1008) were included in the analysis. Patients undergoing TM were more likely to be obese and to have undergone bilateral surgery than those having IBR. However, patients undergoing mastectomy with or without IBR were more likely to experience complications than the TM group (TM: 79, 21⋅0 per cent; mastectomy: 570, 37⋅2 per cent; mastectomy and IBR: 359, 35⋅6 per cent; P < 0⋅001). Breast conservation was possible in 87⋅0 per cent of patients who had TM, and TM did not delay adjuvant treatment.Conclusion: TM may allow high-risk patients who would not be candidates for IBR to avoid mastectomy safely. Further work is needed to explore the comparative patient-reported and cosmetic outcomes of the different approaches, and to establish long-term oncological safety. * Members of the iBRA-2 and TeaM Steering Groups, the Breast Reconstruction Research Collaborative, and the Mammary Fold Academic and Research Collaborative are co-authors of this study and are listed in Appendix S1 (supporting information) Earlier versions of the combined analysis were presented to the

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International multidisciplinary expert panel consensus on breast reconstruction and radiotherapy

Cited by 35 publications

References 147 publications

Quality and reporting of clinical guidelines for breast cancer treatment: A systematic review

Quality and reporting of clinical guidelines for breast cancer treatment: A systematic review

Hypofractionated versus conventional fractionated radiotherapy for breast cancer in patients with reconstructed breast: Toxicity analysis

Therapeutic mammaplasty is a safe and effective alternative to mastectomy with or without immediate breast reconstruction

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