My doctor told me I can’t have breast reconstruction after radiation

Breast cancer survivors who undergo radiation therapy after mastectomy are often advised against implant-based breast reconstruction because of the higher risk of complications. It’s worth noting that implant-based reconstructions are still possible and successful, but the risk of capsular contracture and other complications is higher. Patients can also opt for alternative techniques for breast reconstruction after radiation to reduce the risk of complications.

This article provides an overview of your breast reconstruction options after radiation.

Option 1: Implant Reconstruction

Breast reconstruction with implants involves using silicone gel or saline implants to reshape and recreate the breast. Implants are round or teardrop-shaped silicone shells filled with silicone gel or saline. The implant is placed behind or in front of the pectoral muscles in your chest. Silicone gel implants resemble the natural feel and texture of actual breast tissues, making them extremely look and feel natural.

Studies show that implant reconstructions after radiation have a high risk of capsular contracture and complications. The following are some of the findings of one of the largest studies on the subject:

• Implant reconstruction with radiation therapy had a 45% risk of major complications
• Implant reconstruction without radiation therapy had a 24% risk of major complications
• Radiation therapy before the implant reconstruction led to a 64% risk of complications
• Radiation therapy after the implant reconstruction led to a 58% risk of complications

Option 2: Autologous Reconstruction

Autologous reconstruction is a procedure wherein fat grafting is used to reconstruct the breast tissues. Liposuction is used to harvest the fat tissues from other parts of the body, such as the thighs, abdomen, or hips. The fat is purified and injected into the breasts to enhance their volume. Breast reconstruction with autologous fat grafting is a relatively new technique, but studies suggest that it’s more suitable for women who undergo radiation therapy after the mastectomy.

In a 2016 study titled Mastectomy Reconstruction Outcomes Consortium (MROC), it was found that 39% of women who underwent radiation therapy with implant reconstruction had complications, but only 26% of women who underwent autologous reconstruction had complications. Radiation therapy doubled the risk of complications in implant reconstruction, but it wasn’t associated with higher risks in women with autologous reconstruction.

Importance of Radiation Therapy

Even though undergoing radiation therapy increases the risk of complications with implant reconstruction, that’s no reason to avoid radiation therapy altogether. Breast cancer survivors should opt for radiation therapy after mastectomy to reduce the risk of recurrent breast cancer, especially if the cancer was larger than 2 inches, spread to four or more lymph nodes, or spread to the skin.

Can I Get a Reconstruction?

Women undergoing radiation therapy can opt for breast reconstruction with implants or autologous fat transfer—both options are available. However, some doctors advise against implant reconstruction because it’s linked to a higher risk of complications, as determined by various studies. Autologous reconstruction has a lower risk of complications, but its results aren’t as impressive as implant reconstruction.

Ultimately, you have to weigh several factors when considering breast reconstruction after radiation therapy. Dr. Andres will guide you through all your treatment options and provide all the information you need to make an informed decision. Schedule a consultation today.

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