Achieving autologous breast reconstruction for breast cancer patients in the setting of post-mastectomy radiotherapy

Introduction Breast cancer is now associated with long-term disease-free and overall survival, and in the setting of mastectomy, long term psycho-sexual health becomes an important consideration. To this end, breast reconstruction has been shown to significantly improve quality of life for mastectomy patients. With adjuvant radiotherapy often required in the setting of breast reconstruction, it is unclear what interaction the two can have. Methods A thorough literature review was undertaken to assess the impact of radiotherapy on autologous breast reconstruction, and in particular, the influence of its timing on vessel selection, post-operative complications and both oncologic and cosmetic outcomes. Results A clear benefit was established for delaying reconstruction until after radiotherapy to improve cosmetic outcomes. Although the timing of radiotherapy administration may influence vessel selection and the nature of postoperative complications encountered, overall outcomes were not dissimilar. Likewise, oncologic outcomes have not been shown to be significantly affected by the timing of radiotherapy. Conclusions and implications for cancer survivors Both immediate and delayed breast reconstruction are safe modes of treatment, however patients that are expected to require adjuvant radiotherapy may benefit from delaying reconstruction until completion of oncologic treatment.