27 doctors weighed in:

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
Dr. Devon Webster
Internal Medicine - Oncology
7 doctors agree

In brief: 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.

In brief: 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.
Dr. Devon Webster
Dr. Devon Webster
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Dr. Richard Baxter
Surgery - Plastics
5 doctors agree

In brief: 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.

In brief: 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.
Dr. Richard Baxter
Dr. Richard Baxter
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Dr. Zahid Niazi
Cosmetic Surgery
4 doctors agree

In brief: 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.

In brief: 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.
Dr. Zahid Niazi
Dr. Zahid Niazi
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Dr. Robert Whitfield
Surgery - Plastics
4 doctors agree

In brief: 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.

In brief: 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.
Dr. Robert Whitfield
Dr. Robert Whitfield
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Dr. Tito Vasquez
Surgery - Plastics
3 doctors agree

In brief: 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.

In brief: 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.
Dr. Tito Vasquez
Dr. Tito Vasquez
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1 comment
Dr. Mitchell Kamrava
Depending on the exact clinical scenario it is possible to consider breast conservation in this setting. The Radiation Therapy Oncology Group (RTOG) has a clinical trial open RTOG 1014 which is a phase II study of repeat breast preserving surgery and 3D partial breast re-irradiation for local recurrence of breast carcinoma.
Dr. Todd Sisto
Breast Surgery
2 doctors agree

In brief: 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.

In brief: 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.
Dr. Todd Sisto
Dr. Todd Sisto
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Dr. Robert Stroup
Surgery - Plastics
2 doctors agree

In brief: 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.

In brief: 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.
Dr. Robert Stroup
Dr. Robert Stroup
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Dr. Andrew Turrisi
Radiation Oncology
1 doctor agrees

In brief: 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.

In brief: 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.
Dr. Andrew Turrisi
Dr. Andrew Turrisi
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Dr. Minas Chrysopoulo
Surgery - Plastics
1 doctor agrees

In brief: 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.

In brief: 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.
Dr. Minas Chrysopoulo
Dr. Minas Chrysopoulo
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Dr. Rimma Finkel
Surgery - Plastics
1 doctor agrees

In brief: 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.

In brief: 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.
Dr. Rimma Finkel
Dr. Rimma Finkel
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