Abstract
Original language | English |
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Pages (from-to) | 1327-1340 |
Number of pages | 14 |
Journal | Ann. Surg. |
Volume | 106 |
Issue number | 10 |
DOIs | |
Publication status | Published - 2019 |
Keywords
- advanced cancer
- Article
- breast biopsy
- breast cancer
- breast reconstruction
- breast tissue
- cancer graft
- cancer patient
- cancer radiotherapy
- clinical decision making
- clinical outcome
- deep inferior epigastric perforator flap
- fat necrosis
- human
- intensity modulated radiation therapy
- lymph node biopsy
- mastectomy
- meta analysis (topic)
- morbidity
- multidisciplinary team
- neoadjuvant therapy
- overall survival
- priority journal
- prospective study
- quality of life
- questionnaire
- randomized controlled trial (topic)
- reconstructive surgery
- respiration control
- tissue flap
- adult
- consensus
- controlled study
- Embase
- female
- informed consent
- male
- Medline
- publication
- radiotherapy
- review
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International multidisciplinary expert panel consensus on breast reconstruction and radiotherapy : British Journal of Surgery. / Nava, M.B.; Benson, J.R.; Audretsch, W.; Blondeel, P.; Catanuto, G.; Clemens, M.W.; Cordeiro, P.G.; De Vita, R.; Hammond, D.C.; Jassem, J.; Lozza, L.; Orecchia, R.; Pusic, A.L.; Rancati, A.; Rezai, M.; Scaperrotta, G.; Spano, A.; Winters, Z.E.; Rocco, N.
In: Ann. Surg., Vol. 106, No. 10, 2019, p. 1327-1340.Research output: Contribution to journal › Article › peer-review
}
TY - JOUR
T1 - International multidisciplinary expert panel consensus on breast reconstruction and radiotherapy
T2 - British Journal of Surgery
AU - Nava, M.B.
AU - Benson, J.R.
AU - Audretsch, W.
AU - Blondeel, P.
AU - Catanuto, G.
AU - Clemens, M.W.
AU - Cordeiro, P.G.
AU - De Vita, R.
AU - Hammond, D.C.
AU - Jassem, J.
AU - Lozza, L.
AU - Orecchia, R.
AU - Pusic, A.L.
AU - Rancati, A.
AU - Rezai, M.
AU - Scaperrotta, G.
AU - Spano, A.
AU - Winters, Z.E.
AU - Rocco, N.
N1 - Export Date: 28 February 2020 CODEN: BJSUA Correspondence Address: Rocco, N.; Department of Clinical Medicine and Surgery, University of Naples ‘Federico II’Italy; email: nicolarocco2003@gmail.com References: Cordeiro, P.G., Breast reconstruction after surgery for breast cancer (2008) N Eng J Med, 359, pp. 1590-1601; Kummerow, K.L., Du, L., Penson, D.F., Shyr, Y., Hooks, M.A., Nationwide trends in mastectomy for early-stage breast cancer (2015) JAMA Surg, 150, pp. 9-16; Agarwal, S., Kidwell, K.M., Farberg, A., Kozlow, J.H., Chung, K.C., Momoh, A.O., Immediate reconstruction of the radiated breast: recent trends contrary to traditional standards (2015) Ann Surg Oncol, 22, pp. 2551-2559; McGale, P., Taylor, C., Correa, C., Cutter, D., Duane, F., Effect of radiotherapy after mastectomy and axillary surgery on 10-year recurrence and 20-year breast cancer mortality: meta-analysis of individual patient data for 8135 women in 22 randomised trials (2014) Lancet, 383, pp. 2127-2135; Frasier, L.L., Holden, S., Holden, T., Schumacher, J.R., Leverson, G., Anderson, B., Temporal trends in postmastectomy radiation therapy and breast reconstruction associated with changes in National Comprehensive Cancer Network guidelines (2016) JAMA Oncol, 2, pp. 95-101; 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PY - 2019
Y1 - 2019
N2 - Background: Conflicting evidence challenges clinical decision-making when breast reconstruction is considered in the context of radiotherapy. Current literature was evaluated and key statements on topical issues were generated and discussed by an expert panel at the International Oncoplastic Breast Surgery Meeting in Milan 2017. Methods: Studies on radiotherapy and breast reconstruction (1985 to September 2017) were screened using MEDLINE, Embase and CENTRAL. The literature review yielded 30 controversial key questions. A set of key statements was derived and the highest levels of clinical evidence (LoE) for each of these were summarized. Nineteen panellists convened for dedicated discussions at the International Oncoplastic Breast Surgery Meeting to express agreement, disagreement or abstention for the generated key statements. Results: The literature review identified 1522 peer-reviewed publications. A list of 22 key statements was produced, with the highest LoE recorded for each statement. These ranged from II to IV, with most statements (11 of 22, 50 per cent) supported by LoE III. There was full consensus for nine (41 per cent) of the 22 key statements, and more than 75 per cent agreement was reached for half (11 of 22). Conclusion: Poor evidence exists on which to base patient-informed consent. Low-quality studies are conflicting with wide-ranging treatment options, precluding expert consensus regarding optimal type and timing of breast reconstruction in the context of radiotherapy. There is a need for high-quality evidence from prospective registries and randomized trials in this field. © 2019 BJS Society Ltd Published by John Wiley & Sons Ltd
AB - Background: Conflicting evidence challenges clinical decision-making when breast reconstruction is considered in the context of radiotherapy. Current literature was evaluated and key statements on topical issues were generated and discussed by an expert panel at the International Oncoplastic Breast Surgery Meeting in Milan 2017. Methods: Studies on radiotherapy and breast reconstruction (1985 to September 2017) were screened using MEDLINE, Embase and CENTRAL. The literature review yielded 30 controversial key questions. A set of key statements was derived and the highest levels of clinical evidence (LoE) for each of these were summarized. Nineteen panellists convened for dedicated discussions at the International Oncoplastic Breast Surgery Meeting to express agreement, disagreement or abstention for the generated key statements. Results: The literature review identified 1522 peer-reviewed publications. A list of 22 key statements was produced, with the highest LoE recorded for each statement. These ranged from II to IV, with most statements (11 of 22, 50 per cent) supported by LoE III. There was full consensus for nine (41 per cent) of the 22 key statements, and more than 75 per cent agreement was reached for half (11 of 22). Conclusion: Poor evidence exists on which to base patient-informed consent. Low-quality studies are conflicting with wide-ranging treatment options, precluding expert consensus regarding optimal type and timing of breast reconstruction in the context of radiotherapy. There is a need for high-quality evidence from prospective registries and randomized trials in this field. © 2019 BJS Society Ltd Published by John Wiley & Sons Ltd
KW - advanced cancer
KW - Article
KW - breast biopsy
KW - breast cancer
KW - breast reconstruction
KW - breast tissue
KW - cancer graft
KW - cancer patient
KW - cancer radiotherapy
KW - clinical decision making
KW - clinical outcome
KW - deep inferior epigastric perforator flap
KW - fat necrosis
KW - human
KW - intensity modulated radiation therapy
KW - lymph node biopsy
KW - mastectomy
KW - meta analysis (topic)
KW - morbidity
KW - multidisciplinary team
KW - neoadjuvant therapy
KW - overall survival
KW - priority journal
KW - prospective study
KW - quality of life
KW - questionnaire
KW - randomized controlled trial (topic)
KW - reconstructive surgery
KW - respiration control
KW - tissue flap
KW - adult
KW - consensus
KW - controlled study
KW - Embase
KW - female
KW - informed consent
KW - male
KW - Medline
KW - publication
KW - radiotherapy
KW - review
U2 - 10.1002/bjs.11256
DO - 10.1002/bjs.11256
M3 - Article
VL - 106
SP - 1327
EP - 1340
JO - Ann. Surg.
JF - Ann. Surg.
SN - 1528-1140
IS - 10
ER -