Does radiation therapy affect having breast surgery? I would love to undergo breast reconstruction after my therapy, is that possible?
You should be able. Most women are candidates for breast reconstruction. In many women who require radiation therapy to treat their breast cancer we often delay their breast reconstruction about 6-12 months after radiation. At that time there are numerous options that are available. Usually using your own tissue is preferable. Ask your plastic surgeon.
Breast cancer. Breast reconstruction after radiation in my practice is most commonly performed with a flap like a diep, tug, sgap. The reason is that skin must be added back. If you don't have a flap a tissue expander must be place to help re establish the pocket that existed when the mastectomy was first done. Tissue expander and subsequent implant placement have higher failure rates when XRT has been done.
Yes. It is a common procedure. Your plastic surgeon will describe the available options.
Very common. While the best cosmetic results from plastic reconstructive surgery and radiation therapy to the breast or chest wall work against one another this is a very common scenario that is fairly well understood and managed. Xrt is aimed at minimizing risk of cancer coming back. Plastic surgeon and rad onc will explain time table of the two. Basically implants or flaps must wait for 4 months after xrt.
Vascular compromise. Radiation is wonderful at destroying cancer cells, unfortunately, other than targeting the physical area, it is not specific and may destroy local health cells in close proximity to cancer cells. This will increase the local wound complication rate if local tissues are used for the reconstruction and the dr of distant flaps or free flaps may be preferred to bring in healthy tissue. Fat grafting?
Reconstruction. Reconstruction after mastectomy and radiation therapy is absolutely possible. First and foremost, remember that radiation following mastectomy contributes significantly to improved disease control and survival for most patients with positive lymph nodes or tumors measuring over 5 cm. While radiation may increase the risk of complications following breast reconstruction, the majority of patients can under successful reconstruction. In general, autogenous flaps are preferred over implants in the setting of radiation. Your surgeon, plastic surgeon and radiation oncologist will work together to achieve optimal results.
Definitely possible. Yes, you certainly can, but radiation can affect your results, especially if you have reconstruction with breast implants. Tissue flap reconstructions tend to have fewer complications than implant reconstructions in patients that have had radiation. Please discuss this fully with your plastic surgeon.
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.
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.
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.
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.
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.
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.
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.
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.
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).
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.
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.
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.
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.
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.
Yes. However, cosmetically it is less ideal. Usually breast cancer is treated by surgery, chemotherapy and radiation. Reconstruction is delayed for several months after after radiation. If a person did not require radiation upfront and had reconstruction and years later cancer comes back in the reconstructed site, radiation can be used as part of her treatment.
Yes. It's not ideal but it can be done safely. The patient is treated like any other breast cancer patient without reconstruction.
Yes. Whether your reconstruction involved implants or your own tissue, you may need radiation to reduce your risks of recurrence. Implants are much less tolerant to radiation, however, this may be the best treatment at the time. The radiation specialist may ask us to deflate or even remove the implant to properly treat the area.
Yes. Yes, you can, but radiation can affect your reconstruction (eg hardening, discoloration, shrinking in size, wound healing complications). Tissue flap reconstructions tend to tolerate radiation better than implant reconstructions. Please discuss this fully with your plastic surgeon and radiation oncologist.
Radiation and recon. Most plastic surgeons cringe when it comes to radiating a reconstructed breast. Some of the problems include a tight contracted breast which eventually improves but slowly and does not return to its original state. In some situations hyperbaric oxygen has been used to help reverse some of the effects of radiation by improving oxygen to tissue. Having said this, treating cancer is first priority.