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Radiation Therapy After Breast Reconstruction Causes Higher Complication Rate, Study Finds

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The September issue of Archives of Surgery featured two recent studies performed at American universities that offer helpful insight to mastectomy patients considering breast reconstruction in Houston.

The study found that complications more likely to occur in patients who undergo breast reconstruction immediately following mastectomy, and radiation treatment for breast cancer following breast reconstruction can further increase complication rates.

According to study results, radiation treatment following breast reconstruction triples the risk of complication, and immediate reconstruction following mastectomy makes complications eight times more likely to occur.

Researcher Dr. Rodney Pommier, professor of surgery at Knight Cancer Institute, Oregon Health & Science University, said that the results of the study indicate that it may be prudent for some mastectomy patients to delay breast reconstruction, especially in cases where post-operative radiation treatment is needed.

Dr. Pommier and researchers at OHSU studied 302 mastectomy patients, 152 of whom had breast reconstruction. Of the 152 patients who had breast reconstruction, 131 had reconstruction performed immediately after mastectomy.

Of 100 study patients who underwent radiation treatment after mastectomy, complications occurred in 44 percent of those who had immediate breast reconstruction, but only in 7 percent of those who chose to delay breast reconstruction.

Additionally, breast implant removal was necessary in 31 percent of patients who had radiation after mastectomy, compared to just 6 percent of those who did not have to have radiation, according to study results.

Another recent study found that another breast cancer treatment, chemotherapy, does not affect complication rates in breast reconstruction patients.

Nearly one-third (31 percent) of 163 patients studied by UCSF researchers had a complication that made additional surgery necessary. Some patients in the study had chemotherapy and others did not, but the complication rate wasn’t influenced by whether chemotherapy was performed before surgery, after or not at all.

Dr. Pommier suggests that recent study findings make a good case for determining whether radiation therapy will be needed following mastectomy by performing a sentinel node biopsy on mastectomy patients.

“ If the sentinel node is negative, there is a low probability they would get radiation,” he explained.

Although the findings of these two studies merely confirmed many of the things Houston breast reconstruction surgeons were already seeing clinically, they provide clear evidence that delaying breast reconstruction, especially when radiation therapy is needed, can drastically reduce the need for breast revision surgery.

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