Campbell Andrew R, Didier Alexander J, Sheikh Taha M, Ansari Sami, Watkins Dean E, Fahoury Alan M, Nandwani Swamroop V, Rashid Mohammad
Department of Medicine, College of Medicine and Life Sciences, The University of Toledo, Toledo, OH 43606, USA.
Cancers (Basel). 2024 Aug 23;16(17):2939. doi: 10.3390/cancers16172939.
Immediate breast reconstruction (IBR) following a mastectomy, combined with radiotherapy, presents a multifaceted approach to breast cancer treatment, balancing oncological safety and aesthetic outcomes. IBR, typically involving the use of implants or autologous tissue, aims to restore breast morphology directly after a mastectomy, minimizing the psychological and physical impacts. However, integrating radiotherapy with IBR is complex due to the potential adverse effects on reconstructed tissues. Radiotherapy, essential for reducing local recurrence, can induce fibrosis, capsular contracture, and compromised aesthetic results. This narrative review covers the current trends in the sequencing of breast reconstruction and radiotherapy. We discuss patient selection, timing of radiotherapy, and reconstructive techniques, with special attention paid to quality-of-life outcomes that are increasingly reported in clinical trials. Emerging evidence supports the feasibility of IBR with careful patient selection and tailored therapeutic approaches, although ongoing research is necessary to refine protocols and enhance outcomes. Overall, IBR in the context of radiotherapy remains a promising but intricate treatment modality, requiring a nuanced balance between cancer control and aesthetic restoration.
乳房切除术后即刻乳房重建（IBR）联合放射治疗，是一种多方面的乳腺癌治疗方法，旨在平衡肿瘤学安全性和美学效果。IBR通常涉及使用植入物或自体组织，旨在在乳房切除术后直接恢复乳房形态，将心理和身体影响降至最低。然而，由于对重建组织可能产生的不良影响，将放射治疗与IBR相结合是复杂的。放射治疗对于降低局部复发至关重要，但可能会导致纤维化、包膜挛缩和美学效果受损。本叙述性综述涵盖了乳房重建和放射治疗顺序的当前趋势。我们讨论了患者选择、放射治疗时机和重建技术，并特别关注临床试验中越来越多地报告的生活质量结果。新出现的证据支持在仔细选择患者和采用量身定制的治疗方法的情况下进行IBR的可行性，尽管仍需要进行持续研究以完善方案并提高疗效。总体而言，在放射治疗背景下的IBR仍然是一种有前景但复杂的治疗方式，需要在癌症控制和美学修复之间进行细致的平衡。
