Optimise not compromise : the importance of a multidisciplinary breast cancer patient pathway in the era of oncoplastic and reconstructive surgery

Strach, Madeleine C.; Prasanna, Thiru; Kirova, Youlia M.; Alran, Severine; O'Toole, Sandra; Beith, Jane M.; Poortmans, Philip; McNeil, Catriona M.; Carroll, Susan

doi:10.1016/J.CRITREVONC.2018.11.007

Title

Optimise not compromise : the importance of a multidisciplinary breast cancer patient pathway in the era of oncoplastic and reconstructive surgery

Author

Strach, Madeleine C.

Prasanna, Thiru

Kirova, Youlia M.

Alran, Severine

O'Toole, Sandra

Beith, Jane M.

Poortmans, Philip

McNeil, Catriona M.

Carroll, Susan

Abstract

Modern breast cancer care is a complex multidisciplinary undertaking in which the integrated function of multiple constituent parts is critical, and where changes to one therapeutic component may profoundly influence the delivery and outcomes of another. Oncoplastic and reconstructive breast surgery has evolved in the era of longer survival rates for women with breast cancer and aims to enhance oncological and cosmetic outcomes. However, concurrently there has been an expansion in the indications for post-mastectomy radiation therapy (Abdulkarim et al., 2011; Early Breast Cancer Trialists' Collaborative Group (EBCTCG), 2014; Poortmans et al., 2015; Wang et al., 2011), the recognition of several biologically distinct breast cancer subtypes (Perou et al., 2000; Sorlie et al., 2001, 2003; Cheang et al., 2008, 2009; Sotiriou et al., 2003; Millar et al., 2011; Blows et al., 2010; Schnitt, 2010; Haque et al., 2012; Dai et al., 2015) and the development of recommendations for prophylactic surgery for high-risk women, including BRCA-mutation carriers (James et al., 2006; Domchek et al., 2010). Primary systemic therapy is increasingly utilised yet has varying efficacy depending on tumour biology (Cortazar et al., 2014). In this paper we review the evidence which informs the multidisciplinary team opinion in the era of oncoplastic and reconstructive breast surgery. We aim to describe an optimal multidisciplinary approach which balances competing risks of multimodal therapies to optimise oncological and cosmetic outcomes.

Language

English

Source (journal)

Critical reviews in oncology, hematology / Chemical Rubber Company [Cleveland, Ohio] - Boca Raton, Fla

Publication

New york : Elsevier science inc , 2019

ISSN

1040-8428

DOI

10.1016/J.CRITREVONC.2018.11.007

Volume/pages

134 (2019) , p. 10-21