Annelotte van Bommel

107 Clinicians’ opinion on immediate breast reconstruction For the three reconstruction types, 39%of the surgical oncologists reported lymph node involvement ≥cN2 to be a contra-indication. Plastic surgeons showed a similar response for implant reconstructions (34%), although lower percentages were found for autologous and autologous-implant reconstructions ( Figure 2 ). Overall, surgical oncologists differed in their perspective of adjuvant treatments as contra-indication compared to plastic surgeons ( Table 3 ). No difference between surgical oncologists and plastic surgeons was found for radiotherapy as contra-indication for immediate autologous reconstruction. However, in case of reconstruction using implants (either autologous-implant or implant reconstruction) radiotherapy was less often reported as contra-indication by surgical oncologists compared to plastic surgeons ( Table 3 ). Chemotherapy, neo-adjuvant and specifically adjuvant chemotherapy were more often considered to be a contra-indication for IBR by surgical oncologists compared to plastic surgeons. Adjuvant hormonal therapy was hardly reported as a contra- indication for IBR by any of the clinicians (≤2%, Table 3 ). Table 3. Various treatments reported by clinicians as contra-indication, separated per reconstructive technique. Autologous reconstruction Autologous-implant reconstruction Implant reconstruction Surgical oncologist Plastic surgeon Surgical oncologist Plastic surgeon Surgical oncologist Plastic surgeon Neo-adjuvant therapies are no contra-indication 7% 15% 7% 8% 6% 2% Neo-adjuvant chemotherapy 4% 6% 4% 2% 4% 0% Adjuvant therapies are no contra-indication 0% 8% 0% 3% 0% 2% Adjuvant chemotherapy 7% 3% 7% 2% 5% 2% Adjuvant hormonal therapy 1% 2% 1% 0% 1% 0% Adjuvant radiotherapy 11% 10% 13% 23% 15% 36% 6