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Role of neoadjuvant radiotherapy and immediate autologous breast reconstruction: from a breast surgeon’s perspective

Nina-Marie King (MBBS), David Littlejohn (MBBS, FRACS)

Abstract

Neoadjuvant chemotherapy has an established role in breast cancer for patients who are suitable for immediate autologous tissue breast reconstruction however, the role of neoadjuvant radiotherapy is not as well defined. Short course radiotherapy (typically three weeks) followed by oncological resection with immediate reconstruction offers the benefits of a single operation with a healthy non-irradiated autologous flap without any delays to adjuvant therapies. Unfortunately to date, there is limited high-powered data to support these benefits.

A four-year audit from a single surgeon of patients undergoing immediate autologous breast reconstruction, 26% (5/19) had undertaken neoadjuvant chemoradiotherapy with only one patient demonstrating distant metastases. One patient had complete pathological response to their combined treatment.

This option allows for an increase in immediate reconstructions which give better aesthetic long-term results without the risk of delaying adjuvant treatments or compromising survival.

November, 2020
10.37912/WaggaJOM.0201.08

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