A multidisciplinary view of mastectomy and breast reconstruction: Understanding the challenges

• Published in: Breast (Edinburgh) 2021-04, Vol.56, p.42-52
• Main Authors: Kaidar-Person, Orit, Offersen, Birgitte V., Boersma, Liesbeth J., de Ruysscher, Dirk, Tramm, Trine, Kühn, Thorsten, Gentilini, Oreste, Mátrai, Zoltán, Poortmans, Philip
• Format: Article
• Language: English
• Subjects: Breast cancer; Mastectomy; Nipple sparing; Radiation; Reconstruction; Review; Skin sparing
• ISSN: 0960-9776; 1532-3080
• DOI: 10.1016/j.breast.2021.02.004

The current review paper was written in collaboration with breast cancer surgeons from the European Breast Cancer Research Association of Surgical Trialists (EUBREAST), a breast pathologist from the Danish Breast Cancer Group (DBCG), and representatives from the European SocieTy for Radiotherapy & Oncology (ESTRO) breast cancer course. Herein we summarize the different mastectomies and reconstruction procedures and define high-risk anatomical areas for breast cancer recurrences, to further specify the challenges in the surgical procedure, histopathological evaluation, and target volumes in case of postmastectomy irradiation, as recommended by the ESTRO guidelines according to the surgical procedure. The paper has original figures and illustrations for all disciplines for in-depth understanding of the differences between the procedures. •Mastectomy techniques and reconstruction evolved to improve cosmetic outcomes.•Different techniques maybe associated with different amount of residual breast tissue.•More data is needed to estimate who are the patients at risk for residual disease or recurrence.•Multidisciplinary work needed to individualise treatment for optimal oncological outcomes while maintaining the significant improvements in achieving better cosmesis for these patients.