Cambridge Breast Unit, Cambridge University Hospitals, Cambridge, UK.
Breast J. 2019 Mar;25(2):207-218. doi: 10.1111/tbj.13193. Epub 2019 Feb 1.
The aim of this paper is to discuss and understand the interplay of surgical and radiotherapy (RT) techniques that potentially affect the aesthetic outcomes following breast conservation treatment. It reviews the reported cosmetic outcomes within the practice-changing RT trials incorporating varied fractionation regimes as well as sequence (before, during, or after surgery) over the past two decades. The paper importantly highlights an overall improvement in breast surgical techniques particularly oncoplastic breast conservation techniques due to dedicated and streamlined training of late. Hence, erstwhile complications or sequel of breast surgery and associated post-RT aesthetic concerns may not be of the same variety or magnitude that were noted in the past. Paper thus concludes by highlighting the paradigm shift in the breast surgical practice that will have a bearing on the accuracy of RT outcomes assessed (within or out with clinical trials) with implications as a potential research and outcomes assessment gap.
本文旨在讨论和理解手术和放射治疗（RT）技术的相互作用，这些技术可能会影响保乳治疗后的美容效果。本文回顾了过去二十年中，纳入不同分割方案（手术前、手术中或手术后）的改变实践的 RT 试验中报告的美容结果。该文重要地强调了由于最近的专门和简化培训，乳房手术技术，特别是肿瘤整形保乳技术的整体改善。因此，以前的乳房手术或相关 RT 美容问题的并发症或后遗症可能不会与过去观察到的相同。本文最后强调了乳房手术实践中的范式转变，这将对评估 RT 结果的准确性（临床试验内或外）产生影响，并可能存在潜在的研究和结果评估差距。
