After being diagnosed with breast cancer, 1/3 of women choose to have a mastectomy, or surgical removal of the entire breast, says an October 2008 article by Peter G. Cordeiro, M.D. in "The New England Journal of Medicine." Removal of one or both breasts causes disfigurement and can interfere with a woman's psychological health during the cancer battle. Sometimes radiation therapy is used following the breast removal to ensure destruction of all cancerous cells. Breast cancer reconstruction is an important step in the healing process for some women but can pose complications after radiation therapy.
Site Complications
Traditionally, the reconstruction process is tri-fold; expanders are placed under the chest skin to stretch it and prepare room for an implant, patients wait for tissue expansion to be sufficient, then the actual implant is inserted. Radiation therapy can cause swelling, redness and skin burns on the chest wall. If an expander was not placed prior to radiation therapy, expansion of the skin will be difficult, notes Breastcancer.org. However, if a tissue expander was placed prior to radiation therapy, but not placed correctly or fully expanded, then extra radiation could occur to healthy tissues or the skin may shrink with radiation and not allow for the implant insertion.
Cosmetic
After radiation the skin occasionally becomes scarred or permanently discolored in the irradiated area. Some women see a noticeable difference between the implanted and natural breast in shape, size and general appearance. Unless nipple reconstruction surgery was performed in conjunction with the breast implant, one breast will be missing a nipple and areola and will appear unnatural.
Unplanned Operations
Radiation kills healthy tissues alongside cancerous ones, decreasing the body's immune system response. According to Medical News Today, 31 percent of women required repeat surgical procedures after having an implant after radiation. Rejection of the implant is also a concern, as some women's immune systems will actually fight the implant and work to eject it from the body. The article in "The New England Journal of Medicine" discusses the fact that more women will have scarring and infection when implants are used after radiation, and suggests that women who have had radiation may benefit from the use of autogenous tissue, or tissue from another part of the body, to reconstruct the breast.
References
- American Cancer Society: Breast Reconstruction After Mastectomy
- Breastcancer.org: Reconstruction How Long After Radiation?
- Medical News Today: Reconstruction After Mastectomy And Radiation; When Are The Right Times For Each?
- "The New England Journal of Medicine": Breast Reconstruction After Surgery for Breast Cancer
