Optimising post-operative radiation therapy after oncoplastic
and reconstructive procedures
by Trine Tramm,
Orit Kaidar-Person
The Breast: Published: March 28, 2023
Abstract
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 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.
Highlights
• New surgical procedures for breast cancer poses new
challenges for the radiation oncologists.
• Oncoplastic breast surgery may question the ability to
apply or the need for a tumour bed boost.
• Skin sparing/nipple sparing mastectomies should be planned
to assure clear superficial margins.
• Radiation therapy indications, target volumes, dose and
fractionation should be adapted per case to provide maximal clinical benefit
and reduce toxicity.
• Multidisciplinary teamwork is needed from the time of
diagnosis to plan the most appropriate locoregional therapy.
