How Does Radiation Affect Breast Reconstruction?
When you receive radiation after breast reconstruction surgery, it can cause changes in the reconstructed breast’s appearance and increase the risk of complications such as capsular contracture and delayed healing.
Radiation can also slow down wound healing and affect the body’s ability to heal in the long term, depending on whether there is permanent tissue damage afterward. The longer it takes for an incision to heal, the greater the risk of infection.
Radiation can also cause the skin over an implant or tissue flap to become tighter, tougher, and more rigid. In some cases, a treatment called fat grafting (or “fat injection”) can help soften and improve the skin, thicken the layer of tissue between an implant and the skin, or both.
As a result, some surgeons may recommend you wait until after you finish radiation therapy to have either breast implant reconstruction or flap reconstruction.
Radiation therapy and breast implants
Radiation can increase the risk of certain complications after breast implant reconstruction, including:
tightening, toughening, or thinning of the skin
changes in breast size, position, or shape
implant loss
A reconstructed breast can get firmer and sit higher on the chest after radiation, creating asymmetry with the other breast. Your plastic surgeon may recommend surgery to alter the other breast to restore balance.
Radiation therapy and flap reconstruction
Radiation can increase the risk of certain complications after flap reconstruction, including:
shrinking of the skin
tightening or toughening of the skin
Unlike implants, complete loss of a flap after radiation to a reconstructed breast does not typically happen. 1
Timing radiation before or after breast reconstruction
Depending on several factors, including breast cancer type and stage, your doctor might recommend mastectomy (or lumpectomy), followed by chemotherapy and radiation. But researchers at places like MD Anderson Cancer Center are looking into whether there are benefits to having people receive radiation first, followed by mastectomy with immediate reconstruction. 2 It would mean people who want reconstruction after mastectomy would not have to delay it if they don't want to.
In the meantime, if you’re going to have radiation and are interested in having breast reconstruction, your options are:
delaying breast reconstruction until after radiation is completed
having mastectomy with immediate reconstruction but starting with a tissue expander and then swapping it out for the breast implant after radiation is completed
Ultimately, if you want breast reconstruction, decisions about when to have it and what type to have — as well as when to have radiation — depend on your individual situation. Your cancer care team, including the plastic and breast surgeon and the radiation and medical oncologist, can all help you make an informed choice based on your preferences, anatomy, and cancer-specific treatments.
1. OncoLink. “Radiation Therapy and Breast Reconstruction: Considerations and Timing.” Available at: https://www.oncolink.org/cancers/breast/treatments/radiation-therapy/radiation-therapy-and-breast-reconstruction-considerations-and-timing
2. MD Anderson Cancer Center. “Reconstruction options for breast cancer survivors.” Available at: https://www.mdanderson.org/cancerwise/reconstruction-options-for-breast-cancer-survivors.h00-159463212.html
This information made possible in part through the generous support of www.BreastCenter.com.
— Last updated on September 27, 2023 at 5:09 PM