Post-Mastectomy Breast Reconstruction Considerations in Patients Receiving Adjuvant Radiotherapy

Abstract

This article provides an overview of the following: breast reconstruction in the context of postmastectomy radiation therapy, reconstructive adjacent procedures such as lymphedema surgery, and unmet gaps in patient care including patient education. Postmastectomy radiation therapy is associated with detrimental soft tissue effects and morbidity. The risks of wound healing complications and lymphedema can significantly increase with radiotherapy. This is true regardless of the modality of reconstruction, although autologous reconstruction has been demonstrated to be the most radiation-tolerant. In addition, emerging surgical options for lymphedema such as lymphovenous bypass and vascularized lymph node transfer demonstrate promise. While radiation is a cornerstone of breast cancer management, postmastectomy radiation therapy has detrimental effects to soft tissue and presents reconstructive challenges. Patients who seek reconstruction may be underinformed and would likely benefit from a comprehensive counseling approach.