The impact of radiotherapy in pre-pectoral implant-based breast reconstruction: a narrative review

Background and Objective: Pre-pectoral implant-based reconstruction (PIBR) is becoming increasingly popular. It is known that the data available so far are limited regarding the effect of post-mastectomy radiotherapy (PMRT) in PIBR. This as well true with data about effect of previous breast radiotherapy (RT). Relatively few studies were undertaken and their outcomes were released in the last few years. Some of them were designed to address impact of RT. Others just mentioned its effect on their cohort. Hence this review was undertaken to study the effect of RT (both pre- and post-mastectomy) on PIBR. Methods: A narrative review of literature was undertaken. The search strategy was limited to articles written in English language. A systematic search was performed in all electronic databases (PubMed, Web of Science, Scopus, EMBASE). All studies, over the last 10 years were included, that reported or mentioned effect of RT on patients who had PIBR. The quality of each included study was assessed with the NewcastleOttawa Scale (NOS). Key Content and Findings: Nineteen studies reporting on impact of RT in PIBR or mentioned its effect have met the inclusion criteria. Conclusions: PMRT appears to be well tolerated in immediate PIBR with no excess adverse effects when used with acellular dermal matrix (ADM)/mesh at least in short term. Previous RT per se is not an absolute contraindication to the procedure. More studies are needed.