How Radiation Therapy Affects Breast Reconstruction

Radiation therapy is a common tool available in the treatment of some breast cancers.  Most commonly, radiation therapy is part of the treatment for patients who undergo a lumpectomy, or “partial” mastectomy.  In these cases, radiation is done to the remaining breast tissue to lower the chance of recurrence.  Radiation can also serve a role in some patients undergoing a mastectomy, usually when the following criteria are met:

  • Larger tumor sizes
  • Axillary lymph node involvement with the cancer
  • Close surgical resection margins

Radiation can impact the size, shape, volume and/or projection of the breast, and it can also impact the quality and character of the breast and chest wall skin in the treatment field.  All of these factors are considered when planning for breast reconstruction.

Timing of reconstruction is very important, as reconstruction can have an impact on breast cancer treatment.  Due to the sensitivity of the treatment schedule, your reconstructive surgeon will often work in coordination with your medical and radiation oncologists to determine optimal timing for reconstruction.

Depending on the circumstance, radiation can be done either before or after reconstruction.  Each patient scenario is unique, so you should ask your reconstructive surgeon about the optimal timing of reconstruction, specific to your case.  Importantly, the method of reconstruction will have a significant impact on when the reconstruction is done relative to radiation treatment.  An experienced reconstructive surgeon will choose a plan that is safe, but that also optimizes the aesthetics of your outcome.

In our practice, when radiation therapy is required, we try to avoid the use of implants for reconstruction.  In mastectomy patients who require (or who have had) radiation, DIEP flap reconstruction is the safest approach.  The surgery involves using the patient’s own tissue to reconstruct the breast.  The result is a soft, natural, long-lasting result, despite the need for radiation.

Breast Reconstruction Associates specializes in DIEP flap surgery.  Please do not hesitate to contact us for more information. Scheduling a consultation is simple and allows us to better discuss your situation.