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Current Breast Cancer Reports

Erschienen in:

07.11.2019 | Clinical Trials (JE Lang, Section Editor)

Preoperative Radiotherapy Trials to Facilitate Immediate Breast Reconstruction after Mastectomy

verfasst von: Puneet Singh, Henry M. Kuerer

Erschienen in: Current Breast Cancer Reports | Ausgabe 4/2019

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Abstract

Purpose of Review

Postmastectomy radiotherapy (PMRT) is often a component of treatment algorithms for locally advanced or node-positive breast cancer. Breast reconstruction may be delayed or not performed due to negative effects of PMRT on the reconstruction. Administering radiotherapy in the preoperative setting allows for immediate breast reconstruction (IBR) to be performed in patients who have indications for PMRT and desire IBR. This review summarizes the current literature on this new concept.

Recent Findings

Most prospective treatment protocols included neoadjuvant systemic therapy followed by radiotherapy (RT) dose of 50–50.4 Gy conventionally fractionated and mastectomy with immediate autologous reconstruction after 6–8 weeks. There were no cases of IBR being aborted due to technical complications and overall postoperative complications ranged from 3 to 36%. These were typically non-operatively managed, and cosmetic results when evaluated were favorable. Initial oncologic outcomes indicate low locoregional recurrence rates (≤ 10%) and high 5-year overall survival rates of 87–98%.

Summary

Although published studies are heterogeneous in nature, they suggest that preoperative RT followed by mastectomy with IBR is technically feasible and safe. Larger prospective studies with longer follow-up times may establish this as a new standard in the multidisciplinary treatment of high-risk breast cancer.

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•• Giacalone PL, Rathat G, Daures JP, Benos P, Azria D, Rouleau C. New concept for immediate breast reconstruction for invasive cancers: feasibility, oncological safety and esthetic outcome of post-neoadjuvant therapy immediate breast reconstruction versus delayed breast reconstruction: a prospective pilot study. Breast Cancer Res Treat. 2010;122(2):439–51. https://doi.org/10.1007/s10549-010-0951-7This is the first prospective trial of patients receiving preoperative chemotherapy and immediate breast reconstruction. In this small cohort, there were no differences in early or late complications compared to a group who received postmastectomy radiotherapy and delayed reconstruction and cosmetic outcomes were rated favorably by physicians and patients. CrossRefPubMed

17.

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18.

Baker C, Chao MW, Jassal S, et al. The safety and pathological impact of neoadjuvant radiotherapy for local advanced breast cancer undergoing mastectomy and autologous reconstruction. Cancer Research Conference: San Antonio Breast Cancer Symposium, SABCS. 2017;78(4 Supplement 1).

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Titel: Preoperative Radiotherapy Trials to Facilitate Immediate Breast Reconstruction after Mastectomy
verfasst von: Puneet Singh
Henry M. Kuerer
Publikationsdatum: 07.11.2019
Verlag: Springer US
Erschienen in: Current Breast Cancer Reports / Ausgabe 4/2019
Print ISSN: 1943-4588
Elektronische ISSN: 1943-4596
DOI: https://doi.org/10.1007/s12609-019-00328-0

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