Interaction of Postmastectomy Radiation Treatment With Breast Reconstruction: Many Questions, Emerging Data.

J Natl Cancer Inst

Department of Radiation Oncology, Albert Einstein Healthcare Network, Philadelphia, PA.

Published: February 2018

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http://dx.doi.org/10.1093/jnci/djx177DOI Listing

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Article Synopsis
  • - Breast cancer is the most common cancer among women in Southeast Asia, but access to post-mastectomy reconstruction is unequal due to cultural, economic, and healthcare-related disparities that negatively affect patient outcomes and quality of life.
  • - A systematic review of 15 studies from Southeast Asian countries revealed that cultural preferences and economic barriers significantly influence the choice and access to breast reconstruction techniques, with significant cost differences between procedures.
  • - The findings emphasize the need for targeted interventions to improve education, expand reconstructive options, and address healthcare inequalities to reduce the existing disparities in breast reconstruction access across the region.
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Importance: Postmastectomy radiation therapy (PMRT) improves local-regional disease control and patient survival. Hypofractionation (HF) regimens have comparable efficacy and complication rates with improved quality of life compared with conventional fractionation (CF) schedules. However, the use of HF after mastectomy in patients undergoing breast reconstruction has not been prospectively examined.

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Introduction: Autologous fat grafting (AFG) is a common technique used to enhance aesthetic outcomes in postmastectomy breast reconstruction patients. Adipokines are hormones secreted by adipose tissue that play a critical role in regulating metabolic processes and the immune system. However, dysregulated adipokine secretion and signaling can contribute to the development and progression of cancer by promoting angiogenesis, altering the immune response, and inducing the epithelial mesenchymal transition.

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  • Virtual reality-based exercise rehabilitation (VRER) shows potential for aiding patients with cancer-related dysfunctions, but research in this area is limited and inconsistent.
  • A scoping review examined 25 studies involving VRER, focusing on elements like study type, sample size, and types of cancers involved, with data being gathered from various reputable medical databases.
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Background: Breast cancer surgery related complications are a complex condition influenced by interactions among nerve pathways and the physiological responses to breast surgery. The intensity of this complications displays substantial heterogeneity, dependent on individual patient characteristics, the extent of the surgical procedure performed, and various contributing factors.

Methods: A comprehensive search of electronic databases was conducted to identify relevant randomized controlled trials (RCTs) investigating interventions for post-mastectomy pain syndrome (PMPS).

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