Breast reconstruction and radiotherapy

Mónica Drucker-Zertuche, Área de Cirugía Plástica y Reconstructiva, Instituto Nacional de Cancerología, Secretaría de Salud, Ciudad de México, México
Cecilia González-Martínez, Área de Cirugía Plástica y Reconstructiva, Hospital General Dr. Rubén Leñero. Secretaría de Salud, Ciudad de México, México

Background: Radiotherapy (RT) is frequently indicated in mastectomy patients that have opted for immediate breast reconstruction. The indications for adjuvant RT have been well established and are known to delay or prevent local recurrences and increase overall survival. Nevertheless, RT is known to increase the rate of complications and to reduce the aesthetic outcome in patients undergoing breast reconstruction. The optimal approach for breast reconstruction in patients receiving RT implies a complete evaluation of the indications, risks and benefits of the different options of reconstruction. Although there is no general consensus in the management of these patients, expander-implant breast reconstruction has become a very popular form of breast reconstruction and has become the most common practice for women undergoing mastectomy. Objective: To evaluate long term results, early and late complications, and the incidence of patients requiring corrective surgeries. Method: Retrospective study of a 6-year review of a single surgeon’s experience in breast reconstruction with expanders and implants with and without adjuvant RT in 97 patients. Results: The rate of complications and the rate of patients requiring corrective surgeries in irradiated patients are significant in early follow up. Conclusions: Until know, there is no optimal approach for patients who choose expander-implant breast reconstruction in association with RT.

Keywords: Radiotherapy. Breast reconstruction. Mastectomy. Capsular contracture. Wound healing.