Optimising post-operative radiation therapy after oncoplastic and reconstructive procedures

Surgical techniques for breast cancer have been refined over the past decades to deliver an aesthetic outcome as close as possible to the contralateral intact breast. Current surgery further allows excellent aesthetic outcome even in case of mastectomy, by performing skin sparing or nipple sparing m...

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Bibliographic Details
Published in:Breast (Edinburgh) 2023-06, Vol.69, p.366-374
Main Authors: Tramm, Trine, Kaidar-Person, Orit
Format: Article
Language:English
Subjects:
(s) from the Special Issue on: De-escalation of loco-regional treatment
Edited by Oreste Gentilini, Philip Poortmans, Maria João Cardoso, Elzbieta Senkus-Konefka
Boost
Breast - surgery
Breast cancer
Breast Neoplasms - radiotherapy
Breast Neoplasms - surgery
Female
Humans
Mammaplasty - methods
Mastectomy
Mastectomy - methods
Mastectomy, Subcutaneous
Nipples - surgery
Oncoplastic
Radiation
Reconstruction
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Summary:Surgical techniques for breast cancer have been refined over the past decades to deliver an aesthetic outcome as close as possible to the contralateral intact breast. Current surgery further allows excellent aesthetic outcome even in case of mastectomy, by performing skin sparing or nipple sparing mastectomy in combination with breast reconstruction. In this review we discuss how to optimise post-operative radiation therapy after oncoplastic and breast reconstructive procedures, including dose, fractionation, volumes, surgical margins, and boost application. •New surgical procedures for breast cancer poses new challenges for the radiation oncologists.•Oncoplastic breast surgery may question the ability to apply a tumour bed boost.•Skin sparing/nipple sparing mastectomies should be planned to assure clear superficial margins.•Radiation therapy should be adapted per case to provide maximal clinical benefit and reduce toxicity.•Multidisciplinary teamwork is needed to plan the most appropriate locoregional therapy.
ISSN:0960-9776
1532-3080
DOI:10.1016/j.breast.2023.03.013