Breast reconstruction and radiotherapy: a literature review

Abstract

Breast cancer is the most common malignancy in women worldwide. After mastectomy, many women wish to reconstruct the affected breast and immediate breast reconstruction has been proven oncologically safe compared to mastectomy only. In addition, indications for post-mastectomy radiotherapy (PMRT) sessions are becoming more frequent, due to their relationship with reduced mortality and locoregional recurrence. For this reason, many women who opted for immediate reconstruction underwent radiotherapy with implants or expanders. The objective of this study was to compare the outcome of patients with breast cancer undergoing adjuvant radiotherapy after breast reconstruction with an implant or expander with that of patients who did not need irradiation. A literature review was carried out on the CAPES Journal Portal. The studies are unanimous when it comes to the increased risk of complications between control groups and patients who have undergone PMRT. Reconstruction failure rates were lower and the esthetic results were better in surgeries with implants compared with tissue expanders. Autologous surgeries are apparently safe and should be considered in the context of PMRT. This review did not find sufficient scientific evidence to determine the best technique and the best period for radiotherapy in PMRT indications. The choice of the surgical technique and the time of radiotherapy must be at the discretion of the surgeon and multidisciplinary team of each service, always in a shared decision with the patient.