Prospective Evaluation of the Efficacy and Safety of Prepectoral Immediate One-Stage Prosthetic Breast Reconstruction Versus Two-Stage Expander/Prosthesis Reconstruction in Postoperative Adjuvant Radiotherapy Breast Cancer Patients
women aged 18 to 70；
Newly diagnosed breast cancer patients showing no evidence of distant metastasis on clinical examination and diagnostic workup；
adjuvant radiotherapy is required;
Patients scheduled to undergo nipple-sparing mastectomy (NSM) or skin-sparing mastectomy (SSM) with immediate prepectoral implant-based reconstruction (via open, endoscopic, or robotic approach) require adjuvant radiotherapy AFTER permanent implant placement; OR Patients scheduled for NSM/SSM with two-stage tissue expander/implant reconstruction (with expander placement in either submuscular or prepectoral plane) receive radiotherapy WITH the tissue expander in situ, followed by exchange for permanent implant ≥6 months post-radiotherapy (expander position: submuscular/prepectoral acceptable; surgical approach: open/endoscopic/robotic acceptable);
Stage IV (metastatic) breast cancer;
No prior radiotherapy post-mastectomy;
History of ipsilateral chest wall/axillary radiation therapy;
Immunodeficiency, poorly controlled diabetes (HbA1c >7%), or active tobacco use;