A Clinical Algorithm for Breast Cancer Patients: Exploring Reconstructive Options after Radiation

Abstract

As radiation therapy is used as an adjuvant treatment in an increasing number of women during the management of breast cancer, radiation therapy and its well-known adverse effects pose additional challenges for breast reconstruction. The purpose of this review is to examine recent data on outcomes of various breast reconstruction methods in the setting of radiation therapy and help surgeons and oncologists as well as patients with their decision-making process. Breast reconstruction methods can be categorized into autologous-, implant-, and tissue expander/implant-based, each with its distinct advantages and disadvantages. Autologous and tissue expander/implant are preferred when radiation therapy is expected based on surgical, aesthetic, and patient satisfaction. Use of latissimus dorsi flaps and acellular dermal matrix with tissue expander/implant has shown several advantages to traditional methods. For patients who have a high likelihood of requiring postmastectomy radiation therapy, choosing a breast reconstruction method depends on multiple factors. Patients and surgeons should be aware of the impact of radiation therapy so that they can make a well-informed decision.