Breast Cancer Research and Care

Breast reconstruction is an integral component of comprehensive breast cancer care rather than a merely aesthetic adjunct. For many women, reconstruction is associated with meaningful improvements in body image, psychosocial well-being, and quality of life after mastectomy. Nevertheless, it is not a mandatory part of treatment and represents a preference-sensitive decision. This article presents a clinical perspective, informed by selected literature, clinical guidelines, and institutional practice, on why patients with non-metastatic breast cancer in whom mastectomy is a realistic possibility should be offered reconstructive consultation before surgery. At that stage, reconstructive options remain open, patients have time to reflect, and expectations can be discussed realistically. Counseling should present all legitimate pathways, including implant-based and autologous reconstruction, immediate and delayed timing, the implications of postmastectomy radiotherapy, and no reconstruction with an appropriately planned primary closure. The final plan should be individualized according to oncologic safety, anticipated adjuvant treatment, anatomy, comorbidities, and the surgical burden acceptable to the patient, while also incorporating the patient’s expectations and priorities. Reconstructive consultation should therefore support shared decision-making rather than promote reconstruction, with the final informed choice remaining the patient’s own. Psychological and quality-of-life benefits vary among individuals. The success of early reconstructive involvement should not be measured by reconstruction rates, but by whether patients are able to make informed, realistic, and preference-concordant decisions. We propose a consultation framework addressing oncologic context, reconstructive feasibility, patient priorities, expectation management, treatment decisions, and alternative planning, explicitly including no reconstruction with appropriately planned primary closure when preferred. The framework has not yet undergone formal evaluation.

Background/Objectives: Exercise is increasingly recognized as an effective supportive intervention in breast cancer (BC), with substantial evidence demonstrating benefits on cancer-related fatigue, physical function, and quality of life. However, despite this strong scientific basis, its implementation in routine clinical practice remains inconsistent. Existing exercise oncology frameworks have primarily focused on screening, risk stratification, and referral, with limited availability of practical tools to guide individualized exercise prescription across the BC continuum. Accordingly, this narrative review aimed to synthesize current evidence to develop a clinically applicable, stepwise algorithm for individualized exercise prescription in women with BC. Methods: Current evidence from randomized controlled trials, systematic reviews, meta-analyses, and international clinical guidelines on exercise interventions in women with BC was synthesized narratively, with emphasis on exercise modality, intensity, progression, safety considerations, treatment phase, and patient-specific factors. Results: Aerobic and resistance exercise are safe and effective across different phases of BC care, including active treatment, survivorship, and advanced disease, with consistent improvements in fatigue, physical function, cardiorespiratory fitness, and health-related quality of life. However, heterogeneity in interventions, patient populations, and clinical contexts limits direct translation into clinical practice. To address this implementation gap, the available evidence was translated into a structured clinical algorithm based on the FITT principle (frequency, intensity, time, and type), treatment phase, risk stratification, patient-specific characteristics, treatment-related toxicities, and safety considerations, allowing individualized adaptation to different clinical scenarios. Conclusions: Exercise should be considered a core component of BC care rather than a general lifestyle recommendation. Bridging the evidence-to-implementation gap requires structured, individualized, and clinically applicable approaches to exercise prescription. The proposed algorithm translates current evidence into a structured clinical decision-support framework that may facilitate the routine implementation of individualized exercise prescription across the BC continuum.

It gives me great pleasure to launch the new journal Breast Cancer Research and Care (ISSN 3043-100X) [...]