Breast Reconstruction and Post Mastectomy Radiotherapy: A Primer for Members of a Multidisciplinary Team

Background: Post-mastectomy radiation therapy (PMRT) is a key component inmanaging breast cancer with increased potential for locoregional recurrence. Breastreconstruction has evolved to include various techniques that can be categorizedaccording to the type of reconstruction (implant-based versus autologousreconstruction), and the timing of reconstruction (one versus two-step techniques).Methods/Results: This review article aims to provide a digestible summary ofPMRT in the context of breast reconstruction by summarizing salient existingliterature with a focus on considerations of the plastic surgeon. The main findingssummarized in this review include the technique and timing of breastreconstruction, how breast reconstruction can affect radiation delivery, and the typeof reconstruction. Within implant-based reconstruction, existing data on thelocation of the implant in the context of PMRT and PMRT delivery to the tissueexpander versus permanent implant are reviewed. Each consideration may alter theprobability of successful reconstruction and patient satisfaction.Conclusion: It is essential for the multidisciplinary breast cancer team to haveknowledge of the various reconstructive options, and to understand the safety andcomparative effectiveness of staged reconstruction in the setting of PMRT.Additionally, one must consider that reconstructive procedures may haveimplications on the timely administration of PMRT. This review serves as areference for members of the oncologic care team when discussing reconstructiveoptions with patients who will receive PMRT as part of their treatment plan.