Breast Reconstruction OK Before Radiation
Breast Reconstruction at Same Time as Mastectomy Safe, Say Researchers
"Women Feel Better" continued...
Overall, 70 women had radiation therapy after breast reconstruction -- receiving radiation therapy an average of seven months after the breast reconstruction surgery. The other 15 women received the radiation treatment before their breast reconstruction.
The timing of radiation therapy -- before or after breast reconstruction -- had no significant impact on the complication rates or cosmetic results, the study showed.
By five years later, none of the women who had the TRAM procedure had major complications or required corrective surgery. Also, only 5% of the women who had implants had major complications.
"We had to remove the implants in two of the women for reasons such as infection, but they could undergo the procedure again if they wanted," Anderson says.
Minor complications, such as infection or scarring, occurred in 39% of TRAM patients and 14% of those who had implants, she says.
"But all of these TRAM patients had excellent cosmetic outcomes," Anderson says. "They might have been able to feel a tiny lump of scar tissue on palpitation, but it wasn't visible to the naked eye."
Waiting May Still Be Better
But some experts still aren't convinced that immediate breast reconstruction is a good idea.
Thomas Buchholz, MD, a radiation oncologist at the University of Texas M.D. Anderson Cancer Center in Houston, who was the discussant for the presentation, said that while the study is an important one, he still thinks women are better off delaying breast reconstruction until after radiation therapy is completed.
"The issues are twofold," he tells WebMD. "Does reconstruction negatively affect the delivery of radiation, and which option gives the best cosmetic outcome?
"At M.D. Anderson, we find it advantageous to delay breast reconstruction as it allows us to deliver the radiation therapy as safely as possible," he says. The presence of a new breast or implant makes it harder to hit the target, so radiation might inadvertently damage healthy lung tissue.
Also, studies at M.D. Anderson have suggested that delayed breast reconstruction is associated with better cosmetic results, Buchholz says. "Radiation can cause the implant or rebuilt tissue to scar down. It looks like a rock, becomes contracted and distorted."