Adjuvant radiation therapy after immediate implant-based breast reconstruction

Abstract

The role of radiotherapy in the postmastectomy setting with substantial lymph node burden or locally advanced disease has been well described. In the last decade, the indications for postmastectomy radiotherapy (PMRT) have expanded in light of a measurable disease-free survival benefit, even in T1–2N1-patient subgroup. Concurrently, immediate breast reconstruction (IBR) rates after mastectomy are rapidly increasing. Optimal integration of IBR and PMRT is challenging, as PMRT has a known deleterious effect on reconstruction outcomes and IBR has been reported to pose challenges to PMRT delivery. Implant-based reconstruction is the most common type of IBR performed nowadays. This article reviews the current problems regarding integration of the implant-based IBR with optimum radiation delivery and discusses the advantages and disadvantages of each reconstruction method with PMRT.