Advances in Implant-Based Breast Reconstruction in the Setting of Post-Mastectomy Radiotherapy

BACKGROUND: Breast reconstruction and post-mastectomy radiation therapy (PMRT) have become integral components of comprehensive breast cancer management. The coordination of radiation therapy and reconstruction must balance long-term oncologic safety with optimal aesthetic outcomes. OBJECTIVE: This narrative review aims to evaluate and synthesize the latest advancements in the integration of implant-based breast reconstruction and radiotherapy. Specifically, it seeks to clarify the impact of reconstructive timing, material selection, anatomical placement, and advanced radiation techniques on clinical outcomes. The primary endpoint was defined as the incidence of treatment-related complications, and secondary endpoints included long-term aesthetic outcomes and oncologic safety. METHODS: We systematically screened and synthesized the existing literature by searching core databases, including PubMed, Embase, and Web of Science. RESULTS AND CONCLUSION: Currently, the integration of implant-based breast reconstruction with radiotherapy remains an active area of investigation, with consensus lacking on many key aspects. The integration of implant-based reconstruction and radiotherapy necessitates multidisciplinary collaboration to develop individualized treatment strategies. Future prospective studies are warranted to optimize clinical pathways. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.