Optimal Integration of Postmastectomy Radiotherapy with Breast Reconstruction

Several reconstruction options are utilized after mastectomy, and can be categorized into two major groups; 1) prosthetic implants, which can either be placed in a one-step procedure or with an expander placed at the time of mastectomy and permanent implant placed during a separate delayed surgical procedure; and 2) autologous implants using the patient’s own tissue, which can also occur at the time of mastectomy, or as a delayed procedure after radiotherapy. The approach to reconstruction  often depends on several factors including need for radiation, surgical practice patterns, patient anatomy and comorbidities, and patient preference.  Radiation has been shown to increase the risk for reconstruction complications, especially after prosthetic implant placement.   The optimal type of reconstruction and sequencing of radiation and reconstruction remains controversial.  The timing of various implant and reconstruction procedures may have a significant impact on treatment planning, risk for reconstruction complications and overall cosmesis.

Target Audience

This program is designed to meet the interest of radiation oncologist and residents-in-training.

Learning Objectives

  • Describe the major reconstructive options used after mastectomy as well as timing of reconstruction relative to RT.
  • Describe issues related to sequencing of RT to locoregional control and implant-specific outcomes in patients who receive both neoadjuvant and adjuvant chemotherapy with each type of reconstruction
  • Describe how breast reconstruction and oncoplastic surgery techniques in breast-conserved patients impact the technical delivery of RT and dose to normal tissues. 
Course summary
Available credit: 
  • 1.50 Certificate of Attendance
    This activity was designated for 1.00 AMA PRA Category 1 Credit™.
  • 1.50 SA-CME

    The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council of Continuing Medical Education to provide continuing medical education for physicians.

    The American Society for Radiation Oncology (ASTRO) designates this Enduring material for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    This activity meets the American Board of Radiology's criteria for a self-assessment activity in the ABR's Maintenance of Certification program. Participation in this course in combination with the successful completion of the corresponding assessment and course evaluation adheres to the guidelines established by the ABR for 1.50 self-assessment credits.

Course opens: 
01/07/2015
Course expires: 
01/06/2018
Cost:
$105.00
Rating: 
0

The following people served as the developers of this activity and their disclosures are listed below.

  • Barbara Fowble, MD, is employed as a professor at University of California, San Francisco and has no financial relationships with a commercial interest.
  • Alice Ho, MD, is employed at Memorial Sloan Kettering Cancer Center and has no financial relationships with a commercial interest.

  • Babak Mehrara, MD, is employed at Memorial Sloan Kettering Cancer Center and has no financial relationships with a commercial interest.

  • Hani Sbitany, MD, is employed at the University of California, San Francisco and has no financial relationships with a commercial interest.

Additionally, the Education and CME/MOC Committees had control over the content of this activity.

 

Disclosure link: 
Committee Disclosure

The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council of Continuing Medical Education to provide continuing education to physicians.

ASTRO is awarded Deemed Status by the American Board of Radiology to provide SA-CME as part of Part II Maintenance of Certification.

 

Available Credit

  • 1.50 Certificate of Attendance
    This activity was designated for 1.00 AMA PRA Category 1 Credit™.
  • 1.50 SA-CME

    The American Society for Radiation Oncology (ASTRO) is accredited by the Accreditation Council of Continuing Medical Education to provide continuing medical education for physicians.

    The American Society for Radiation Oncology (ASTRO) designates this Enduring material for a maximum of 1.00 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

    This activity meets the American Board of Radiology's criteria for a self-assessment activity in the ABR's Maintenance of Certification program. Participation in this course in combination with the successful completion of the corresponding assessment and course evaluation adheres to the guidelines established by the ABR for 1.50 self-assessment credits.

Price

Cost:
$105.00
Please login or register to take this course.

Course Fees:
ASTRO members must log in to the ASTRO website to view and receive the discounted member rate.

  • Nonmember: $105
  • Member: $55

Policies:
No refunds, extensions, or substitutions will be made for those participants who, for any reason, have not completed the course by the end of the qualification date. The qualification date for each course is listed in the course catalog on the ASTRO website under availability.

Participants using ASTRO's online courses to satisfy the requirement of a Maintenance of Certification (MOC) program should verify the number, type and availability dates of any course before making a purchase. No refunds, extensions, or substitutions will be made for participants who have purchased courses that do not align with their MOC requirement.

The course and its materials will only be available on the ASTRO website for that 3 year period regardless of purchase date. At the expiration of the qualification, participants will no longer have access to the course or its materials. ASTRO reserves the right to remove a course before the end of its qualification period.

 

 

Required Hardware/software

One of the two latest versions of Google Chrome, Mozilla Firefox, Internet Explorer or Safari.