A member asked:

Does radiation therapy affect having breast reconstruction?

32 doctors weighed in across 14 answers

Yes.: There are two types of breast reconstruction following mastectomy: "flaps", where tissue is transferred from another part of the body to the chest wall, and "implants", where an expander is placed under the chest muscle and slowly inflated to create space for an implant. Radiation therapy affects the skin, making tissue expansion more difficult, but not impossible. With flaps, less of an issue.

Answered 3/24/2013

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Dr. David Yan answered

Yes: Radiation can have adverse effects on both implant based reconstruction as well as flap based reconstruction. Radiation can result in wound complications, capsular contracture, fat necrosis, among other things. Unfortunately, you don't always know if you're going to need radiation until after your mastectomy.

Answered 9/28/2016

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Yes: Radiation always demands extra caution and consideration toward breast reconstruction. Having a surgeon who is experienced and board-certified will help ensure that patient safety and satisfaction are always the primary concern.

Answered 3/24/2013

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Yes: Radiation affects both implants and flaps in that the surrounding tissue does not heal or stretch as well and has higher complication rates overall. Care should be take with any reconstruction is tissue that has been or will be radiatiated as it will react differently once it has been radiated.

Answered 3/11/2015

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Dr. Todd Sisto answered

Specializes in Plastic Surgery

Yes!-adversely gene-: -rally. Prior to the advent of the wound vac and alloderm risk of failure very high but could always use flap recon as a "lifeboat operation". Now, almost any pt can safely choose to have rec. Answer depends somewhat upon whether rad is planned or already done.

Answered 4/25/2015

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Breast Radiation: Readiation can have mild or severe effects on breast reconstruction. In some cases you may need additional survey to bring healthy tissue from other parts of the body to complete your reconstruction.

Answered 4/24/2016

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Radiation effects: Radiation can decrease the circulation to breast tissue and can make the tissues "stiffer". As a result, a pre-existing reconstruction can be compromised, or a future reconstruction can be more difficult.

Answered 2/3/2017

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Breast cancer: I currently recommend that my patients have immediate breast reconstruction regardless of the need for post mastectomy radiation therapy. The simple reasoning is that it is the best opportunity to utilize the breast skin. I prefer to do a diep flap or another flap reconstruction when i know a patient is going to have radiation. I then manage any decrease in size or change in shape with fat graft.

Answered 4/5/2014

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Yes but +outweigh-: Radiation is one of the best treatments available to treat and lower the recurrence rates of breast cancer. Unfortunately it is indiscriminate and will damage both diseases and healthy tissues which may increase the risk of wound healing problems with free flaps or capsular contracture with implants. Fat injections may help to mitigate radiation therapy (early reports).

Answered 4/1/2013

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Reconstruction: Is complex. It is an operation, it may involve using a foreign body, or tissues from another part of your body. Operations and foreign bodies always have risks. Radiated tissue heals less well because the blood supply is compromised. We have learned to do this. Each case has special aspects. Benefit and risk must be discussed and understood by all.

Answered 4/1/2013

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Dr. Joseph Mele answered

Specializes in Plastic Surgery

Without a doubt.: The main goal of breast cancer treatment is to remove the cancer cells. Radiation is often used to decrease the risk of local recurrence. Radiation is indiscriminate in that it kills cancer and normal cells too. The result is tougher, tighter skin that has a reduced blood supply. The incidence of complications associated with breast reconstruction is higher after radiation, esp. With implants.

Answered 9/28/2016

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In a big way: Radiation doubles the rate of complications in many studies. It causes a vasculitis that impairs blood flow to the tissues for life. Delaying reconstruction for a minimum of 6 months after rt is necessary to minimize the likelihood of early failure of implant reconstruction.

Answered 5/14/2014

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Possibly: Women who need radiation for their breast cancer can still safely have reconstructions and end up with a good cosmetic result. Radiation can significantly improve the cure rate and should not be avoided due to concerns about reconstruction. There are many ways to combine rt and reconstruction and you should speak with an experienced team.

Answered 1/28/2015

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Dr. Eugene Sidoti answered

Specializes in Plastic Surgery

Yes: You should not avoid having radiation if it is recommended for your breast cancer treatment. It may make breast reconstruction a bit more challenging but usually does not prevent reconstruction. You should definitely consult a board certified plastic surgeon with experience in breast reconstruction to get more specific information concerning your treatment.

Answered 3/30/2016

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