Breast cancer remains a major global health burden, accounting for an estimated 2.3 million new cases, 685,000 deaths, and approximately 20 million disability-adjusted life years annually. Invasive ductal carcinoma (IDC), the most common invasive subtype, is biologically heterogeneous and frequently managed with lumpectomy or mastectomy in non-metastatic disease. Although these procedures are essential for oncologic control, they often result in breast deformity, compromised soft tissue integrity, delayed healing, and substantial psychosocial impact, thereby increasing the need for effective reconstructive strategies. This narrative review synthesises current evidence on platelet-rich plasma (PRP) as a regenerative adjunct in breast reconstruction following IDC surgery. Current evidence suggests that PRP may improve graft viability, vascularisation, tissue integration, wound healing, aesthetic outcomes, and patient satisfaction, particularly when used in conjunction with autologous fat grafting. PRP has also shown potential utility in complex reconstructive settings, including radiated or compromised tissue beds, although supporting evidence remains limited. Importantly, available clinical data do not indicate increased rates of locoregional recurrence or metastasis, while emerging preclinical findings suggest that PRP does not promote tumour progression and may exert inhibitory effects under certain experimental conditions. Nevertheless, the evidence base remains heterogeneous, with substantial variation in PRP preparation protocols, leukocyte content, activation methods, study design, and outcome assessment, and long-term oncologic surveillance data are still lacking. Overall, PRP appears to be a promising but evolving adjunctive strategy in post-oncologic breast reconstruction after mastectomy or lumpectomy for IDC. Standardised protocols, larger comparative studies, and long-term follow-up are needed to define its optimal clinical role, durability, and oncologic safety.