According to one observational study revealed at SABCS last week, radiation therapy was found to increase complications and decrease patient-reported satisfaction in breast cancer patients who received implant reconstruction, but not in those who received autologous (natural tissue) reconstruction.
Led by Dr. Reshman Jagsi, Professor and Deputy Chair of Radiation Oncology at the University of Michigan, the study concluded that women who plan to have radiation therapy to treat breast cancer have a better chance of reconstructive success when their breasts are rebuilt with their own fatty tissue, rather than with breast implants.
Although the high rate of complications associated with implants and radiation is well known, most studies have been conducted by single institutions or physicians. Jagsi’s study analyzed patient satisfaction surveys and medical records of 2,014 breast cancer patients across 11 medical institutions.
Radiation therapy was associated with more than double the odds of developing complications in patients who received implants, but it was not associated with complications in those who received autologous reconstruction:
- 29% of radiated patients and 22% of non-radiated patients experienced at least one complication in the first year following reconstruction
- 34% of radiated patients and 23% of non-radiated patients experienced at least one complication within 2 years after reconstruction
- 11% of radiated patients with implants experienced reconstructive failure, compared with 3% of non-radiated patients within the first two years
Any surgery, including breast reconstruction, has the potential for complications, and women who have mastectomy combined with breast reconstruction, especially autologous reconstruction, tend to experience more complications than women who have mastectomy alone (more surgery, greater odds of problems). Most women who have breast reconstruction don’t experience serious problems, but some develop one or more common complications including infection, seroma, hematoma or delayed wound healing. Women who have reconstruction with breast implants are also susceptible to implant rupture/leak, wrinkling, rippling, and extrusion (when the implant breaks through the skin).
Some women have breast implants after radiation and seem to do well. If you’ve been treated or will be treated with radiation therapy and you’re considering reconstruction with implants, talk to plastic surgeons who have plenty of experience with these combined factors, and who can assess your breast skin and tissue.
“Impact of radiotherapy on complications and patient-reported satisfaction with breast reconstruction: Findings from the prospective multicenter MROC study” [S3-07]. http://www.ascopost.com/News/44207