Oncoplastic breast consortium recommendations for mastectomy and whole breast reconstruction in the setting of post-mastectomy radiation therapy

Weber, Walter P. and Shaw, Jane and Pusic, Andrea and Wyld, Lynda and Morrow, Monica and King, Tari and Mátrai, Zoltán and Heil, Jörg and Fitzal, Florian and Potter, Shelley and Rubio, Isabel T. and Cardoso, Maria-Joao and Gentilini, Oreste D. and Galimberti, Viviana and Sacchini, Virgilio and Rutgers, Emiel J. T. and Benson, John R. and Allweis, Tanir M. and Haug, Martin and Paulinelli, Regis R. and Kovacs, Tibor and Harder, Yves and Gulluoglu, Bahadir M. and Gonzalez, Eduardo and Faridi, Andree and Elder, Elisabeth and Dubsky, Peter and Blohmer, Jens-Uwe and Bjelic-Radisic, Vesna and Barry, Mitchel and Hay, Susanne D. and Bowles, Kimberly and French, James and Reitsamer, Roland and Koller, Rupert and Schrenk, Peter and Kauer-Dorner, Daniela and Biazus, Jorge and Brenelli, Fabricio and Letzkus, Jaime and Saccilotto, Ramon and Joukainen, Sarianna and Kauhanen, Susanna and Karhunen-Enckell, Ulla and Hoffmann, Juergen and Kneser, Ulrich and Kühn, Thorsten and Kontos, Michalis and Tampaki, Ekaterini C. and Carmon, Moshe and Hadar, Tal and Catanuto, Giuseppe and Garcia-Etienne, Carlos A. and Koppert, Linetta and Gouveia, Pedro F. and Lagergren, Jakob and Svensjö, Tor and Maggi, Nadia and Kappos, Elisabeth A. and Schwab, Fabienne D. and Castrezana, Liliana and Steffens, Daniel and Krol, Janna and Tausch, Christoph and Günthert, Andreas and Knauer, Michael and Katapodi, Maria C. and Bucher, Susanne and Hauser, Nik and Kurzeder, Christian and Mucklow, Rosine and Tsoutsou, Pelagia G. and Sezer, Atakan and Çakmak, Güldeniz K. and Karanlik, Hasan and Fairbrother, Patricia and Romics, Laszlo and Montagna, Giacomo and Urban, Cicero and Walker, Melanie and Formenti, Silvia C. and Gruber, Guenther and Zimmermann, Frank and Zwahlen, Daniel R. and Kuemmel, Sherko and El-Tamer, Mahmoud and Vrancken Peeters, Marie J. and Kaidar-Person, Orit and Gnant, Michael and Poortmans, Philip and de Boniface, Jana (2022) Oncoplastic breast consortium recommendations for mastectomy and whole breast reconstruction in the setting of post-mastectomy radiation therapy. The Breast, 63. pp. 123-139. ISSN 0960-9776

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Official URL: https://doi.org/10.1016/j.breast.2022.03.008

Abstract

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.

Item Type: Journal Article
Keywords: Breast cancer, Post-mastectomy radiotherapy, Nipple-sparing mastectomy, Implant-based breast reconstruction, Autologous breast reconstruction
Faculty: Faculty of Health, Education, Medicine & Social Care
Depositing User: Lisa Blanshard
Date Deposited: 14 Apr 2022 09:18
Last Modified: 31 May 2022 16:17
URI: https://arro.anglia.ac.uk/id/eprint/707499

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