A member asked:

If cancer comes back in the same breast after having a breast-sparing surgery, will i need a mastectomy then? will i be able to have breast reconstruction even though i have had radiation?

27 doctors weighed in across 10 answers
Dr. Devon Webster answered

Specializes in Medical Oncology

Yes: Yes to both. Since you can't have radiation twice in the same breast, most women need a mastectomy if the cancer returns after breast-sparing surgery. You have several reconstruction options after previous radiation, depending on how your breast tissue responded to radiation. Talk to a plastic surgeon about options.

Answered 3/24/2013

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Maybe: Recurrence after radiation most often means mastectomy. Unfortunately, after radiation for breast cancer, the tissue is changed in a way that limits the options for reconstruction. Ordinarily the simplest method uses a tissue expander followed by an implant, but radiated tissue doesn't expand well and capsular contracture is common. Flaps such as diep or tram are preferable in that instance.

Answered 11/7/2015

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Yes: Under normal circumstances, several reconstructive options can be offered to you after breast conservation surgery and/or radiation. In most cases, radiation can not be offered again due to limits of the body to a lifetime dose of radiation. Reconstruction after breast sparing surgery is still a very common occurrence. Speak to a plastic surgeon regarding all the options.

Answered 7/7/2015

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Maybe: As far as mastectomy with recurrence, the best person to speak to is your breast surgeon as they should be aware of the most recent studies on radiation and recurrence. As far as reconstruction, implants are more complicated with radiation and generally a flap reconstruction is a better alternative. The best option is to speak with a board certified plastic surgeon about this.

Answered 3/24/2013

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Yes to both: If the breast has already been irradiated and a cancer recurs, the only option is mastectomy. Breast reconstruction is usually possible; but choices are limited, the procedure must be done cautiously, and the complication rate is higher.

Answered 11/8/2015

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Dr. Todd Sisto answered

Specializes in Plastic Surgery

Yes & qualified Yes: Local recurrence in a previously radiated breast makes reconstruction riskier and more difficult. If there is marked skin thickening and fibrosis or deformity, flap reconstruction is probably a better choice. If those findings do not pertain, methods using expanders and prostheses plus allpoderm (which require no donor site)can be tried first, saving a flap as a "backup"or "lifeboat" operation.

Answered 4/25/2015

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Yes: Most women that suffer a recurrence of their breast cancer in the same breast after breast conservation (lumpectomy and radiation) go on to have a mastectomy. It is certainly possible to have breast reconstruction even though you have had previous radiation.

Answered 10/4/2016

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Breast cancer: Yes you can have breast reconstruction. If there is a recurrence after lumpectomy and radiation then after your work up you choose to have a mastectomy and immediate breast reconstruction i typically recommend the use if your own tissue for the reconstruction. Several wound healing issues can develop on previously radiated and operated tissues.

Answered 9/28/2016

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Mastectomy: Was mandatory before nsabp b-04. Little data trying to conserve after an in breast relapse, and all would first offer mastectomy. A second breast salvage is unproven. Excision + partial breast option would be an outside the norm discussion. Breast reconstruction, immediate or later, can be done, on case by case basis. Discuss with your provider team.

Answered 9/28/2016

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Dr. Zahid Niazi answered

Specializes in Cosmetic Surgery

Yes,?implant ?tummy: The option of breast reconstruction is always available for majority of patients undergoing cancer treatment. If the longterm radiation effect on the tissues is limited and you don't require expansion then a one stage implant breast mound reconstruction is still possible but commonly an autogenous tissue reconstruction is required if radiation damage is more severe. Be sure to get brca gene tested.

Answered 7/20/2013

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