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Reconstruction after radiation?

Page last modified on: October 15, 2008

Question from Liz: What are the reconstructions for breasts treated with radiation? Can you still use implants?: Answers —Joseph Serletti, M.D., F.A.C.S.: You can. In my experience it's best if you work with a dedicated radiation oncologist. If you work with someone like that you can really maximize the results. When you combine radiation with implants there's always some potential for compromise. Even when you work with someone very dedicated to delivering the radiation and working around the implants, it still doesn't preclude some of the complications that we see. There are some patients with whom only an implant reconstruction is possible. Even when we have to deal with that in the setting of radiation, obviously we still go ahead with doing an implant reconstruction.; Jennifer Sabol, M.D., F.A.C.S.: I think there are some patients who have had a mastectomy and followed that with radiation who are now looking at a delayed radiation and are hearing delayed reconstruction and are often told that they are not a candidate for an implant because of the previous radiation.; Joseph Serletti, M.D., F.A.C.S.: The patients that Jennifer just talked about are probably the hardest patients to get a satisfactory implant breast reconstruction on. What we do in those patients is we combine a tissue expander with a latissimus flap, which is a skin and muscle flap from the back. With that combination we can usually get a successful implant reconstruction. What the latissimus flap does is provide some unirradiated muscle and skin which is brought into the radiated mastectomy area. This allows satisfactory expansion of the tissue. I want to emphasize, in most patients who've had irradiated mastectomies, the preferred method is to use an autogenous reconstruction, like the TRAM flap. But in patients who don't have adequate tissue for a TRAM flap, the latissimus flap with a tissue expander is a good alternative.

On Wednesday, May 16, 2007, the Ask-the-Expert Online Conference was called Reconstruction Updates. Joseph Serletti, M.D. and moderator Jennifer Sabol, M.D. answered your questions about breast reconstruction.

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

Joseph M. Serletti, M.D., F.A.C.S. is professor of surgery and chief of the Division of Plastic Surgery at the University of Pennsylvania. He is a pioneer in the field of free flap autologous breast reconstruction.

Jennifer Sabol, M.D., F.A.C.S. is a breast surgeon who directs the newly developed Breast Care Center at Lankenau Hospital in Wynnewood, Pa. Among her many interests, Dr. Sabol spearheads several research initiatives to advance the care for women with breast cancer and improve methods of breast cancer detection and treatment.