The Effects of Postmastectomy Adjuvant Radiotherapy on Immediate Two-Stage Prosthetic Breast Reconstruction

Sir: We read with great interest the Viewpoint1 published by Maione et al. in the May issue of the Journal entitled “The Effects of Postmastectomy Adjuvant Radiotherapy on Immediate Two-Stage Prosthetic Breast Reconstruction: A Systematic Review.” The first author (D.R.) knows the authors personally, and they have contributed a lot in the field of regenerative surgery, and their report highlights again how important this topic is. The concept, the technique, and the application they describe to overcome radiotherapy-induced complications in immediate expander-implant breast reconstruction are not new. More specifically, I personally described and published this method for the first time in 20112 when I was working at Cagliari University, widening then the indications with further experiences reported also in this Journal,3–5 when I returned to La Sapienza University in Rome. We are aware of the use of our protocol in more and more breast centers, especially in the north of Italy (Bonomi et al.), and this is a further input for us to continue. A multicenter, prospective, randomized study with longer follow-up as suggested by Cordeiro6 would probably help. Again, we congratulate Maione et al. for pursuing solutions to this difficult problem. DISCLOSURE All authors hereby declare that they do not have any potential conflict of interests and that they have not received funding for this work. Diego Ribuffo, M.D. Federico Lo Torto, M.D. Matteo Atzeni, M.D. Francesco Serratore, M.D. Department of Surgery P. Valdoni Sapienza University Rome, Italy