Influence of Radiation Dose to Reconstructed Breast Following Mastectomy on Complication in Breast Cancer Patients Undergoing Two-Stage Prosthetic Breast Reconstruction

Conclusions: This study is the first to demonstrate a dose-response relationship between risk of complications and near Dmax, where hypofractionated regimen or boost RT can play an important role. Rigorous RT-quality assurance program and modification of dose constraints could be considered as a critically important component for ongoing trials of hypofractionation. Based on our findings, we initiated a multi-center retrospective study (KROG 18-04) and a prospective study (NCT03523078) to validate our findings. Introduction Breast reconstruction provides important psychosocial, cosmetic, and quality of life benefits for women undergoing mastectomy (1, 2), which accounts for approximately more than 60% of mastectomy women in the US (3). As recent evidence has widened the indications of post-mastectomy radiation therapy (RT) to early-stage node-positive breast cancer (4), an increasing number of patients is currently referred for adjuvant RT to the reconstructed breast, which has put treating physicians in a challenging situation. There is substantial evidence from small case series and prospective cohort studies demonstrating that RT significantly increases complications following breast reconstruction regardless of the type of reconstructive surgery and timing of surgery (5, 6). Breasts reconstructed with implants are known to be more susceptible to RT-related complications compared with breasts reconstructed with autologous tissue (7). However, autologous approaches, w...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research