We still have a lot to learn when it comes to optimizing the integration of post-mastectomy radiation and breast reconstruction. This excellent review summarizes modern surgical and radiation approaches. First of all, while autologous reconstruction is expensive with outcomes highly dependent on surgeon experience, most data points to it resulting in fewer complications—with or without PMRT—than the much more common two-stage implant reconstruction. Speaking of, this author’s own recent investigation also suggests that a single-stage direct-to-implant approach also results in fewer complications, especially when PRT is used. They also remind us that the limited data we have suggests the use of scar boost, skin bolus and/or protons may all increase risk of complications. Good news is the authors used available data to create an online tool to estimate individual risk of reconstructive complications. | Naoum, Curr Breast Cancer Rep 2023
