Australian surgeons are calling for a shift in attitudes towards breast reconstructive surgery following radiotherapy.
The study, published in the Royal Australasian College of Surgeons ANZ Journal of Surgery, revealed that traditionally patients who undergo radiotherapy treatment after a mastectomy have been deemed unsuitable for immediate reconstructive surgery, particularly when compared to patients that did not require radiotherapy. In recent years, however, the evidence globally has increasingly suggested that reconstructive surgery for these patients is both safe and beneficial.
Dr Farid Meybodi, a breast surgeon from Westmead Breast Cancer Institute, was part of a group of researchers that surveyed fellow breast surgeons to assess the current attitudes and practices in the setting of postmastectomy radiotherapy. He hopes that the results of the survey will promote further discussion amongst the profession, and ultimately greater choices for women recovering from a mastectomy.
As the research has evolved we wanted to see how many breast surgeons have begun to incorporate immediate breast reconstructive surgery for radiotherapy patients into their practice, and how many still believe it to be unsafe. We were surprised that the number of surgeons favouring delayed breast reconstruction was more than 60 per cent, Dr Meybodi said.
Despite many earlier studies reporting the deleterious effects of post-mastectomy radiotherapy on reconstruction outcomes, more recent studies have demonstrated that patients are willing to accept less than perfect aesthetic results for functional and psychological benefits of immediate breast reconstruction.
The message we hope to promote is that rather than making a blanket rule that women who undergo radiotherapy shouldnt have reconstructive surgery, we should be accepting the latest evidence and providing our patients with more choices.
Our study has already involved many members of our professional society and we are hopeful that even more will read it and reflect upon the latest literature, and how it relates to their practice.
