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Reconstruction how long after radiation?

Page last modified on: September 19, 2008
Question from LeslieB: I am headed for radiation for six and one-half weeks and want to know first, how long should I wait before reconstruction and is it going to be difficult to have implants?
Answers —Marisa Weiss, M.D., president and founder: If you have mastectomy with placement of a tissue expander, and then you finish radiation to that area, most plastic surgeons want the area of the redness and swelling to heal before they go in to remove the expander and put in the permanent implant. At some places, like at Memorial Sloan-Kettering in New York, they tend to switch the expander for the implant before radiation to the chest wall is delivered.
Lydia Komarnicky, M.D.: Sometimes, a plastic surgeon and certainly the radiation oncologist will want the saline expander expanded to its fullest before starting radiation. The reason is that once you start radiation, you can't continue expanding during the treatment. This will throw off the very accurate beam that was set up to the breast in the initial time in the department. Then, after the radiation is complete, the expander can be replaced with the actual implant.
Marisa Weiss, M.D., president and founder: The coordination between the plastic surgery reconstruction and the radiation requires good communication. For example, sometimes the expander is expanded too much before the radiation, distorting the chest wall and other normal tissues in the area that needs to be radiated. It then could push the chest wall down towards the heart. In this situation, the radiation oncologist may request that some fluid be removed from the expander to improve the radiation distribution to the area at risk and to avoid dose to the adjacent normal tissue.

Each of you needs to work closely with your own radiation oncologist to find out how the information we provided tonight can be useful for you, based on your unique circumstances.

On Wednesday, March 17, 2004, our Ask-the-Expert Online Conference was called Radiation Therapy Updates. Lydia T. Komarnicky, M.D. and Marisa Weiss, M.D. answered your questions about advances in radiation therapy: the newest and best techniques, combining radiation therapy with other treatments, ways to manage, reduce or eliminate side effects, and more.

The materials presented in these conferences do not necessarily reflect the views of breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.

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Meet the Experts

Lydia Komarnicky, M.D.Lydia Komarnicky, M.D. is a Philadelphia-trained physician and a graduate of the University of Pennsylvania and the Medical College of Pennsylvania.

Marisa Weiss, M.D. is a radiation oncologist specializing in breast cancer and the founder, president, and guiding force behind Breastcancer.org.

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