Oncoplastic breast consortium recommendations for mastectomy and whole breast reconstruction in the setting of post-mastectomy radiation therapy

Breast

Roland Reitsamer¹  Regis R. Paulinelli²  Andrea Pusic³  Andreas Günthert⁴  Jens-Uwe Blohmer⁵  Yves Harder⁶  Elisabeth A. Kappos⁶  Elisabeth Elder⁷  Laszlo Romics⁸  Silvia C. Formenti⁹  Jane Shaw⁹  Susanna Kauhanen^1,10  Hasan Karanlik^1,11  Ramon Saccilotto^1,12  Atakan Sezer^1,13  Susanne Bucher^1,14  Bahadir M. Gulluoglu^1,14  Cicero Urban^1,15  Giacomo Montagna^1,16  Maria C. Katapodi^1,17  Christian Kurzeder^1,17  Melanie Walker^1,17  Walter Paul Weber^1,17  Pelagia G. Tsoutsou^1,17  Rosine Mucklow^1,17  Nik Hauser^1,17  Giuseppe Catanuto^1,18  Jana de Boniface^1,19  Ulrich Kneser^2,20  Zoltán Mátrai^2,21  John Benson^2,21  Michael Gnant^2,21  Oreste Davide Gentilini^2,22  Viviana Galimberti^2,23  Janna Krol^2,23  Peter Schrenk^2,24  Philip Poortmans^2,25  Liliana Castrezana^2,26  Monica Morrow^2,27  Maria-Joao Cardoso^2,28  Martin Haug^2,29  Mitchel Barry^3,30  Florian Fitzal^3,31  Rupert Koller^3,32  Carlos A. Garcia-Etienne^3,33  Shelley Potter^3,34  Tari King^3,35  Moshe Carmon^3,36  Sarianna Joukainen^3,37  Jakob Lagergren^3,38  Peter Dubsky^3,39  Ulla Karhunen-Enckell^4,40  Susanne Dieroff Hay^4,41  Isabel T. Rubio^4,42  James French^4,42  Jörg Heil^4,43  Christoph Tausch^4,44  Michael Knauer^4,45  Daniel Steffens^4,46  Orit Kaidar-Person^4,47  Tanir M. Allweis^4,48  Sherko Kuemmel^4,49  Daniel Rudolf Zwahlen^5,50  Juergen Hoffmann^5,51  Eduardo Gonzalez^5,52  Güldeniz Karadeniz Çakmak^5,53  Nadia Maggi^5,54  Tibor Kovacs^5,54  Virgilio Sacchini^5,55  Linetta Koppert^5,56  Mahmoud El-Tamer^5,57  Emiel J.T. Rutgers^5,58  Andree Faridi^5,59  Ekaterini Christina Tampaki^6,60  Vesna Bjelic-Radisic^6,61  Daniela Kauer-Dorner^6,62  Fabienne D. Schwab^6,63  Pedro F. Gouveia^6,64  Guenther Gruber^6,65  Lynda Wyld^6,65  Marie Jeanne Vrancken Peeters^6,66  Fabricio Brenelli^6,67  Jorge Biazus^6,68  Thorsten Kühn^6,69  Tal Hadar^7,70  Tor Svensjö^7,71  Frank Zimmermann^7,72  Michalis Kontos^7,73  Patricia Fairbrother^7,73  Jaime Letzkus^7,74  Kimberly Bowles^7,74 

[1] Breast Center, Hirslanden Clinic St. Anna, Lucerne, Switzerland;Cambridge Breast Unit, Cambridge University Hospitals NHS Foundation TRUST, School of Medicine, Anglia Ruskin University, Cambridge, UK;Corresponding author. University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland.;Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden;Faculty of Biomedical Sciences, Università Della Svizzera Italiana, Lugano, Switzerland;Faculty of Medicine, Hebrew University, Jerusalem, Israel;Guy's and St. Thomas' NHS Foundation Trust London, UK;Patient Advocacy Group, Oncoplastic Breast Consortium, Basel, Switzerland;University of Basel, Basel, Switzerland;Breast Cancer Center, Kepler University Hospital, Linz, Austria;Breast Center Eastern Switzerland, St. Gallen, Switzerland;Breast Center Salzburg, University Clinic Salzburg, Paracelsus Medical University Salzburg, Salzburg, Austria;Breast Center Zurich, Zurich, Switzerland;Breast Center and Department of Plastic, Reconstructive, Aesthetic and Handsurgery University Hospital Basel, University of Basel, Basel, Switzerland;Breast Center, Hirslanden Clinic Aarau, Aarau, Frauenarztzentrum Aargau AG, Baden, Switzerland;Breast Center, Lucerne Cantonal Hospital, Lucerne, Switzerland;Breast Center, University Hospital Basel, Basel, Switzerland;Breast Center, University Hospital Düsseldorf, Düsseldorf, Germany;Breast Endocrine and General Surgery Unit, The Alfred, Melbourne, Australia;Breast Oncology Division, University of Campinas, Campinas, São Paulo, Brazil;Breast Surgery Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA;Breast Surgical Oncology, Clinica Universidad de Navarra, Madrid, Spain;Breast Unit, Champalimaud Clinical Centre, Champalimaud Foundation, And Nova Medical School, Lisbon, Portugal;Breast Unit, Helios University Hospital, University Witten/Herdecke, Wuppertal, Germany;Breast Unit, Hospital Nossa Senhora Das Graças, Curitiba, Brazil;Breast Unit, Ospedale Santa Chiara, Trento, Italy;Brigham and Women's/Dana Farber Cancer Center, USA;Bristol Centre for Surgical Research, Bristol Medical School, University of Bristol, Clifton, Bristol, UK;Cambridge Breast Unit, Addenbrooke's Hospital Cambridge, Cambridge, UK;Departament of Mastology, Breast Unit- Instituto de Oncología Angel H Roffo, Buenos Aires Univesity. Buenos Aires, Argentina;Department of Breast and Sarcoma Surgery, National Institute of Oncology, Budapest, Hungary;Department of Gynecology and Breast Center, Charité University Hospital, Berlin, Germany;Department of Hand, Plastic and Reconstructive Surgery - Burn Center, BG Trauma Center Ludwigshafen/Rhine, Hand and Plastic Surgery, University Heidelberg, Heidelberg, Germany;Department of Obstetrics and Gynecology, University of Heidelberg, Medical School, Heidelberg, Germany;Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK;Department of Plastic Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland;Department of Plastic, Aesthetic and Reconstructive Surgery, Vienna Health Services, Clinic Landstrasse and Clinic Ottakring, Vienna, Austria;Department of Plastic, Reconstructive Surgeryand Burn Unit, KAT Athens Hospital and Trauma Center, Athens, Greece;Department of Plastic, Reconstructive and Aesthetic Surgery, Ospedale Regionale di Lugano, Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland;Department of Radiooncology, University Hospital Vienna, Austria;Department of Senology/Breast Center, University Hospital Bonn, Germany;Department of Surgery and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria;Department of Surgery, Brigham and Women's Hospital / Dana Farber Cancer Institute, USA;Department of Surgery, Capio St Goran's Hospital, Stockholm, Sweden;Department of Surgery, Central Hospital, Kristianstad, Sweden;Department of Surgery, Erasmus MC Cancer Institute, Rotterdam, the Netherlands;Department of Surgery, New Victoria Hospital, Glasgow, UK;Department of Surgery, The Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, the Netherlands;Department of Surgery, The School of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, Turkey;Department of Surgery, Trakya University Medical School Hospital, Turkey;Division of Breast Surgery, Universidade Federal Do Rio Grande Do Sul (UFRGS), Porto Alegre, Brazil;Federal University of Goiás, Araújo Jorge Hospital, Goiás Anti-Cancer Association, Goiás, Brazil;Gyn-zentrum, Luzern, Switzerland;;Hadassah Medical Center &IRCCS Ospedale San Raffaele, Milan, Italy;Interdisciplinary Breast Center, Klinikum Esslingen, Germany;Istanbul University Institute of Oncology, Turkey;Istituto Europeo di Oncologia, IRCCS, Milan, Italy;Jiahui Internatioonal Hospital Shanghai, China;Kuopio University Hospital, Kuopio, Finland;Marmara University School of Medicine, Istanbul, Turkey;Mater Misericordiae University Hospital, Dublin, Ireland;Multidisciplinary Breast Unit, Azienda Ospedaliera Cannizzaro, Catania, Italy;National and Kapodistrian University of Athens, Greece;Patient Advocacy Group, Oncoplastic Breast Consortium, Basel, Switzerland;Patient Advocacy Group, Oncoplastic Breast Consortium, Breakthrough Breast Cancer, Association Breast Surgery UKBCC, Kedleston, UK;Patient Advocacy Group, Oncoplastic Breast Consortium, Not Putting on A Shirt, Pittsburgh, USA;Patient Advocacy Group, Oncoplastic Breast Consortium, President, the Swedish Breast Cancer Association, Stockholm, Sweden;San Borja Arriaran Clinical Hospital, University of Chile, Chile;Tampere University Hospital, Department of Surgery and Tays Cancer Center, Tampere, Finland;Tel Aviv Soraski Medical Center, Israel;University Hospital Geneva, University of Geneva, Faculty of Medicine, Geneva, Switzerland;University of Basel, Basel, Switzerland;Westmead Breast Cancer Institute, Westmead Hospital, University of Sydney, Australia;

关键词: Breast cancer;    Post-mastectomy radiotherapy;    Nipple-sparing mastectomy;    Implant-based breast reconstruction;    Autologous breast reconstruction;   

DOI  :  

来源: DOAJ

【 摘 要 】

Aim: Demand for nipple- and skin- sparing mastectomy (NSM/SSM) with immediate breast reconstruction (BR) has increased at the same time as indications for post-mastectomy radiation therapy (PMRT) have broadened. The aim of the Oncoplastic Breast Consortium initiative was to address relevant questions arising with this clinically challenging scenario. Methods: A large global panel of oncologic, oncoplastic and reconstructive breast surgeons, patient advocates and radiation oncologists developed recommendations for clinical practice in an iterative process based on the principles of Delphi methodology. Results: The panel agreed that surgical technique for NSM/SSM should not be formally modified when PMRT is planned with preference for autologous over implant-based BR due to lower risk of long-term complications and support for immediate and delayed-immediate reconstructive approaches. Nevertheless, it was strongly believed that PMRT is not an absolute contraindication for implant-based or other types of BR, but no specific recommendations regarding implant positioning, use of mesh or timing were made due to absence of high-quality evidence. The panel endorsed use of patient-reported outcomes in clinical practice. It was acknowledged that the shape and size of reconstructed breasts can hinder radiotherapy planning and attention to details of PMRT techniques is important in determining aesthetic outcomes after immediate BR. Conclusions: The panel endorsed the need for prospective, ideally randomised phase III studies and for surgical and radiation oncology teams to work together for determination of optimal sequencing and techniques for PMRT for each patient in the context of BR

【 授权许可】

Unknown