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Practice Point
Radiation therapy, neoadjuvant systemic therapy and reconstruction – Sequencing
The ideal sequencing of radiation therapy, neoadjuvant systemic therapy and reconstruction is unknown and therefore should be discussed by a multidisciplinary team (MDT), ideally before surgery or radiation therapy.
An intensive multidisciplinary and interactive patient-involving approach is required to individualise the best combination of the sequence and type of breast reconstruction and radiation therapy (Level of evidence – V)
Strong evidence for efficacy with a substantial clinical benefit, strongly recommended
How this guidance was developed
No evidence-based source recommendation was identified for this topic, which was considered an important aspect of care. This practice point was developed using an expert consensus process based on clinical expertise and knowledge of the Australian healthcare context and based on information contained within the NCCN 2018 (USA) guidelines. It was subsequently informed by the subsequently the ESMO 2019 (Europe) guidelines which included a recommendation graded 'A' (using ESMO methods adapted from the Infectious Diseases Society of America-United States Public Health Service Grading System) based on very low level evidence/expert opinion.
Radiation therapy, neoadjuvant systemic therapy and reconstruction – Sequencing
Practice Point
The ideal sequencing of radiation therapy, neoadjuvant systemic therapy and reconstruction is unknown and therefore should be discussed by a multidisciplinary team (MDT), ideally before surgery or radiation therapy.
Principles in action
Safe and quality care
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Multidisciplinary care
No evidence-based source recommendation was identified for this topic, which was considered an important aspect of care. This practice point was developed using an expert consensus process based on clinical expertise and knowledge of the Australian healthcare context and based on information contained within the NCCN 2018 (USA) guidelines. It was subsequently informed by the subsequently the ESMO 2019 (Europe) guidelines which included a recommendation graded 'A' (using ESMO methods adapted from the Infectious Diseases Society of America-United States Public Health Service Grading System) based on very low level evidence/expert opinion.