The “Breast REconstruction and NeoAdjuvant Radiotherapy (BRENAR)” pilot study explores a novel strategy in the treatment of breast cancer. This pilot is being conducted in three Dutch hospitals. In current breast cancer treatment there is a growing trend of patients opting for immediate reconstruction followed by adjuvant postmastectomy radiotherapy. This trend arises from an increasing number of women desiring immediate reconstruction and requiring radiotherapy. However, there is a high risk of complications associated with (immediate) breast reconstruction in combination with radiotherapy, especially in cases involving implant-based reconstructions (upto 40%). The  complications seen are fat necrosis, fibrosis, impaired wound healing, and compromised aesthetics. In the Netherlands, there is considerable variation in breast cancer treatment protocols concerning the timing of reconstruction (immediate single-stage, immediate two-stage, delayed), treatment choices (implant, tissue expander, autologous), and radiotherapy techniques.

To promote greater uniformity in these treatment protocols, prevent radiation-related damage to the reconstruction, and still offer the option of immediate breast reconstruction, this pilot administers neoadjuvant radiotherapy. Internationally, similar small-scale pilots have been conducted, showing no increase in postoperative complications nor oncological disadvantages. Therefore, we anticipate positive outcomes in this pilot. We will assess postoperative complications at three and twelve months following definitive reconstruction, quality of life and aesthetics.

This pilot includes 20 patients. If positive results are observed, this pilot will serve as the foundation for a larger randomized study comparing patients receiving neoadjuvant radiotherapy with conventional therapy.