Breast Reconstruction Timing -
Radiotherapy and Breast Reconstruction
Radiotherapy can be a very important part of the treatment for certain breast cancer patients. It is usually offered to patients who only have part of the breast removed (breast conserving surgery) as it has been shown to reduce the chances of breast cancer recurring in the remaining breast tissue. Indeed breast conserving surgery and radiotherapy is as effective as mastectomy for many patients in treating their cancer. You will be advised by your cancer surgeon if this is an option.
However, certain patients that have a mastectomy have also been shown to benefit from radiotherapy. It’s likely use can be predicted in some patients but it will often only be known if radiotherapy is needed after the mastectomy is performed and the cancer analysed.
When given, radiotherapy can damage normal tissue as well as cancer cells. It can result in changes in the skin colour and cause firmness and shrinkage in healthy breast tissue. It can have the same effects in tissues that have been used to reconstruct a breast. If a silicone implant is present then it can cause an alarming rise in potential complications of capsule formation (firmness from scar tissue) or infection.
Due to the problems caused by radiotherapy it can have an impact on the decision making of the methods used and the timing of breast reconstruction as summarized below.
- If radiotherapy is planned or has already been given then implant reconstruction should be avoided in the majority of cases.
- When radiotherapy is almost certainly planned you may be recommended to delay reconstruction until all your treatment is completed. There is nothing more disappointing for patient and surgeon to see a good reconstruction be adversely affected by radiotherapy.
- If radiotherapy is a possibility then it is acceptable to take either the cautious route of delayed reconstruction or proceed to primary reconstruction and deal with radiotherapy problems if they occur.
- It must be emphasized that not all patients get strong adverse affects from radiotherapy. This makes definitive advice difficult.
