Breast Cancer Care: Radiation after Reconstruction with Breast Implants

According to the American Cancer Society, as of 2012, over 2.9 million women in the United States with a history of breast cancer were living cancer-free or undergoing treatment. There are various methods of breast cancer treatment, including surgery, radiation, and systemic therapy. Many women with breast implants who undergo radiation treatment, such as chemotherapy, are concerned as to whether implants should be placed before or after radiation. Below, board-certified plastic and reconstructive surgeon Dr. Franklyn Elliott explains the answer to this breast cancer care question.

breast reconstruction atlanta georgiaRadiation therapy often follows breast-conserving surgery and uses high-energy beams and particles to kill cancer cells in the body in order to prevent the recurrence of breast cancer. While it can destroy cancer cells remaining in the breast, chest wall, and underarm area after surgery, radiation affects blood supply to skin and deep tissues which can cause the occurrence of scar tissue.

However, this does not mean that women who have saline or silicone breast implants cannot have radiation therapy. Rather, the presence of implants just makes radiation therapy planning more multifaceted. Radiation can cause scarring and hardening of the implant, leading to a less natural look.  With breast implants being in the area of treatment, they would be subject to the changes in blood supply caused by radiation.

As the skin and muscle scars after radiation therapy, so does the scar capsule surrounding the implant. This increases the threat of capsular contracture, which occurs when a patient’s body reacts to a foreign object and forms a “capsule” around the implant. The additional scarring causes the capsule to tighten around the implant, creating a condition in which the breast appears hardened and uncharacteristic of a healthy breast. While the implant itself remains unaffected, the tissue around it can be modified greatly. This condition can generally be treated with success though with capsular surgery and implant exchange.

Typically without extensive complication, breast cancer patients can have radiation therapy after TRAM flap reconstruction procedures with tissue expanders. However, it is essential to remember that the tissue will still be affected (i.e., scarring, changes in blood flow). This means the skin and fat used in reconstruction may not be as soft and natural-feeling as it would be if it were not part of radiation therapy. On the other hand depending in the radiation therapy technique the TRAM flap may be – in up to 60% of cases- be essentially unaffected by the radiation.   Dr. Elliott can delay breast reconstruction if his patients need radiation so that they may use healthy tissue that has not been affected by the treatment. Although each patient’s situation is unique, Dr. Elliott generally prefers the TRAM flap procedure in situations where radiation therapy is involved.

Ultimately, the decision to undergo radiation with the presence of breast implants is the patient’s choice. If you are interested in breast revision for implant removal or want to learn more, please contact our office today to schedule a consultation. Stay up to date on the latest breast cancer and breast reconstruction news by following Dr. Elliott on FacebookTwitter, and Google+.