Oncoplastic breast consortium recommendations for mastectomy and whole breast reconstruction in the setting of post-mastectomy radiation therapy
Küçük Resim Yok
Tarih
2022
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Churchill Livingstone
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Aim: Demand for nipple- and skin- sparing mastectomy (NSM/SSM) with immediate breast reconstruction (BR) has increased at the same time as indications for post-mastectomy radiation therapy (PMRT) have broadened. The aim of the Oncoplastic Breast Consortium initiative was to address relevant questions arising with this clinically challenging scenario. Methods: A large global panel of oncologic, oncoplastic and reconstructive breast surgeons, patient advocates and radiation oncologists developed recommendations for clinical practice in an iterative process based on the principles of Delphi methodology. Results: The panel agreed that surgical technique for NSM/SSM should not be formally modified when PMRT is planned with preference for autologous over implant-based BR due to lower risk of long-term complications and support for immediate and delayed-immediate reconstructive approaches. Nevertheless, it was strongly believed that PMRT is not an absolute contraindication for implant-based or other types of BR, but no specific recommendations regarding implant positioning, use of mesh or timing were made due to absence of high-quality evidence. The panel endorsed use of patient-reported outcomes in clinical practice. It was acknowledged that the shape and size of reconstructed breasts can hinder radiotherapy planning and attention to details of PMRT techniques is important in determining aesthetic outcomes after immediate BR. Conclusions: The panel endorsed the need for prospective, ideally randomised phase III studies and for surgical and radiation oncology teams to work together for determination of optimal sequencing and techniques for PMRT for each patient in the context of BR © 2022 The Authors
Açıklama
Anahtar Kelimeler
Autologous Breast Reconstruction; Breast Cancer; Implant-Based Breast Reconstruction; Nipple-Sparing Mastectomy; Post-Mastectomy Radiotherapy, Accuracy; Article; Breast Cancer; Breast Reconstruction; Cancer Radiotherapy; Cancer Surgery; Cochrane Library; Delphi Study; Dosimetry; Embase; Female; Graft Necrosis; Human; Hypopigmentation; Mastectomy; Medline; Morbidity; Nipple-Sparing Mastectomy; Organs At Risk; Outcome Assessment; Questionnaire; Radiation Oncologist; Radiation Oncology; Risk Factor; Skin-Sparing Mastectomy; Surgeon; Surgical Technique; Toxicity; Breast Tumor; Mastectomy; Nipple; Procedures; Prospective Study; Breast Neoplasms; Female; Humans; Mammaplasty; Mastectomy; Nipples; Prospective Studies
Kaynak
Breast
WoS Q Değeri
Scopus Q Değeri
Q1
Cilt
63
