Current Therapies for Breast Cancer: What the Plastic Surgeon Needs to Know

Breast reconstruction after mastectomy or breast-conserving surgery requires careful planning that accounts for patient preference, comorbidities, tumor characteristics, and anticipated neoadjuvant or adjuvant therapies. Advances in the treatment of breast cancer have led to evolving recommendations for these therapies, with each influencing not just the complications from surgery but also the long-term outcomes. This narrative review summarizes the current indications for these therapies and their potential impacts on breast reconstruction. Contemporary recommendations for postmastectomy radiation therapy, chemotherapy, immunotherapy, endocrine therapy, and other targeted therapies are explored, with an emphasis placed on perioperative management of systemic therapies and how they may influence reconstructive decision-making. Understanding the nuances of these therapies enables plastic surgeons to be strategic in the timing of reconstruction through individualized planning and can improve reconstructive success. As breast cancer treatment evolves, familiarity with oncologic management is essential for achieving safe, patient-centered care.