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Oncoplastic breast surgery: follow-up radiation therapy

Oncoplastic breast surgery: follow-up radiation therapy

For breast cancer patients, plastic surgery can be an overwhelming prospect. They may worry about surgery complications, cancer resurgence and also the cosmetic outcomes of breast cancer surgery. Oncoplastic breast surgery differs to more traditional breast cancer treatment procedures; it is a cancer removal and breast reconstruction surgery that removes the tumour and reconstructs the breast in the same procedure, for superior cosmetic outcomes.

This kind of breast conserving surgery is less traumatic, since only one operation is performed and no muscle tissue is used in reconstructive surgery. This procedure allows for better and shorter recovery times. It also allows the patient to have radiation therapy after breast reconstruction.

This article will explore whether radiotherapy is necessary after oncoplastic surgery and whether this is safe. We’ll also look at reasons to undergo radiation therapy after breast cancer surgery and whether oncoplastic breast conserving surgery will impact therapy or cosmetic outcomes.

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Is radiation therapy necessary after breast cancer surgery?

Radiation therapy is usually recommended after breast conserving surgery, where only a small amount of breast tissue is removed, common for early breast cancer surgery. It is a necessary stage to reduce the chances of cancer cells remaining, which could lead to cancer resurgence. Radiotherapy is strongly recommended after a lumpectomy where cancer removal margins are small. It is also recommended after a partial mastectomy where margins are larger but still relatively small.

However, if the breast cancer patient has undergone a full mastectomy or a double mastectomy, they may be at a lower risk of cancer resurgence since much breast tissue is removed, leading to a higher chance of all of the invasive breast cancer being removed.

With oncoplastic surgery, the aim is to conserve as much of the breast tissue as possible, as a result, there may be higher odds of cancer cells remaining, since cancer removal margins are lower. Radiation therapy is highly recommended after oncoplastic breast conservation surgery.

Read about the advantages and disadvantages of oncoplastic breast surgery here.

Other reasons to get follow-up radiation therapy

Regardless of which type of breast surgery the patient has undergone; it is often prudent to follow up surgery with radiation therapy as it is not uncommon for cancer cells to be found in surrounding breast tissue, the chest wall or lymph nodes. This may depend on the patient’s stage of cancer development; advanced tumours will have a higher chance of spreading to nearby tissue and even a full mastectomy may not resolve this. In most cases, the patient’s oncologist will suggest to follow-up with radiotherapy to lower the chances of cancer recurrence.

Radiation therapy is usually carried out for three weeks, with sessions taking place Monday to Friday – a radiation therapy schedule can be a challenging and busy time. However, it is still a vital part of having the best chance of eliminating cancer cells in the breast.

Is radiation therapy safe after breast cancer surgery?

In cases of traditional breast cancer surgeries, radiation therapy is carried out prior to any breast reconstruction. With traditional breast reconstruction surgeries, materials other than natural tissue is used. For example, in the case of a mastectomy, with a full reconstruction, this will involve synthetic implants – breast implants can become damaged from radiation therapy.

It is safe for patients to have radiation therapy after breast conserving surgery. Radiation therapy is usually offered around a month after breast cancer surgery, to allow time for wounds to heal. However, if there are complications such as infections, this will be delayed until it is safe to proceed with the treatment.

Oncoplastic breast surgery

Oncoplastic breast conservation combines cancer removal and reconstruction into one surgery, so radiation therapy must be carried out after the partial breast reconstruction. However, it is safe to undergo radiation therapy after reconstruction. This is because no synthetic materials are used in the reconstructive surgery. Initially, the breast surgeon will remove the cancer tissue, and then use natural tissue from the patient’s armpit, upper back, or chest wall to reconstruct the breasts. This type of procedure does not require implants or other materials that may be damaged by radiation therapy.

However, due to the more complex and multifaceted nature of this breast conservation surgery, patient recovery time may be longer than for a lumpectomy for example. This is because more tissue is disturbed in this kind of oncoplastic surgery. The benefit is that the patient will not need two recovery periods as a result of multiple surgeries. However, it may be necessary to wait slightly longer before undergoing radiation therapy, in order to ensure that the patient’s wounds have healed.

Is radiation therapy impacted by oncoplastic breast surgery?

Breast cancer patients may be considering weather, oncoplastic surgery will impact the efficacy of radiation therapy. Due to oncoplastic breast surgery utilising natural tissue, there is no evidence that suggests that radiation therapy is impaired in any way after breast conserving therapy. Furthermore, the aesthetics of the reconstruction will remain generally unaltered aside from possible breast shrinkage, which is a normal side effect of radiation therapy on the breasts.

Frequently asked questions

How long after breast surgery can a patient get radiation therapy?

After a patient has undergone breast surgery of any kind, they will be required to wait before having radiation therapy. This can vary based on the type of surgery and how quickly the patient heals, as well as whether they encounter any complications during this time. For some, who have undergone breast conservation surgery, such as a lumpectomy, it can be as little as three to four weeks before radiation treatment can begin. For others, especially, full mastectomy patients, it can be up to eight weeks or perhaps longer before radiotherapy can begin.

Does reconstruction affect the ability to check for breast cancer recurrence?

Breast reconstruction in oncoplastic procedures neither affects the incidence nor the detection of cancer recurrence in the breast tissue. In fact, immediate reconstruction results in the best preservation of anatomical structures, leading to better cosmetic outcome and simpler cancer detection.

Related pages

Understanding breast conserving surgery

Comparing oncoplastic breast surgeries and mastectomies