Plastic and Reconstructive Surgery

Skip Navigation LinksHome > August 2008 - Volume 122 - Issue 2 > Options in Reconstructing the Irradiated Breast
Plastic & Reconstructive Surgery:
doi: 10.1097/PRS.0b013e31817d605f
Breast: Special Topic

Options in Reconstructing the Irradiated Breast

Spear, Scott L. M.D.; Boehmler, James H. M.D.; Bogue, David P. M.D.; Mafi, Amir A. B.S.

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Background: As radiation therapy becomes more prevalent in the treatment of breast cancer, more patients requesting breast reconstruction for mastectomy defects will have a history of radiation therapy.

Methods: A retrospective chart review study was performed of a single surgeon’s 5-year experience with reconstruction of the irradiated breast.

Results: Sixty-six primary patients and 13 secondary patients were treated over a 5-year period (2001–2005). Of the 66 primary patients, 25 (38 percent) presented for reconstruction after recurrence following prior breast conservation therapy: 12 had prosthetic based reconstructions (with or without a latissimus flap) and 13 had autologous reconstructions. Twenty-five patients (38 percent) presented after mastectomy followed by radiation therapy: six had prosthetic-based constructions and 19 had autologous reconstructions. Twelve patients (18 percent) had their reconstructions performed before radiation therapy: nine had implant-based reconstructions and three had autologous reconstructions. Four patients (6 percent) presented for corrections of breast conservation therapy deformities. One hundred seventy-five total operations were performed for the primary patients, with an average of 2.65 operations per patient. Thirteen patients were treated secondarily after previous reconstruction at other institutions with a variety of reconstruction methods used. Twenty-eight total operations were performed for the secondary patients, with an average of 2.2 operations per patient. Capsular contracture rates using the prosthetic score are reported.

Conclusions: Because of the variability of presentation of the irradiated breast cancer patient, there is no one method of reconstruction ideally suited for all irradiated patients. In this 5-year review, the authors found that with careful patient evaluation and selection, good results can be attained regardless of reconstructive method.

©2008American Society of Plastic Surgeons


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