Can a Reconstructed Breast Get Cancer? | Insights & Facts

Following a mastectomy and breast reconstruction, patients may find themselves left with many questions, fears, and emotions. One common fear is breast cancer reoccurrence after reconstruction. There are a variety of factors that can cause cancer to return, such as genetics and the stage of cancer that the patient had before reconstruction. 

Can a Reconstructed Breast Get Cancer Again?

Understanding the Breast Cancer Risk Factors Post-Reconstruction

After getting a breast reconstruction, there is still a potential risk of developing breast cancer again. There is around a 2-3% chance of cancer recurrence after reconstruction, making it fairly uncommon, but still a possibility. 

Breast reconstruction utilizes a woman's own tissue flaps from the abdomen, back, or thighs to rebuild the breast shape. This transferred tissue contains blood vessels, fat, skin, and sometimes muscle. Even though this tissue comes from donor sites on the body, the cells still carry the patient's intrinsic breast cancer risk factors and DNA. For patients who had breast cancer initially, that inherent cancer risk still remains for surrounding breast cells or tissue throughout the body. 

If any potentially precancerous cells are present within the flap tissue used for reconstruction, they may slowly undergo mutations over the years that allow malignancy to form. Or, in the case of patients who were BRCA gene positive in the past, they remain at risk for developing cancer in the conserved natural breast tissue or the reconstructed breast later on due to those gene mutations. Continued cancer screening of the reconstructed breast is critical for detecting any concerning changes or masses as soon as possible. 

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Reconstruction does not increase the risk of developing breast cancer again. However, there are some important factors to consider. For implant-based reconstruction, the implants themselves do not affect recurrence risk. If radiation therapy after mastectomy, there is some concern implants may obscure visualization on future mammograms, which could potentially delay cancer detection.

With autologous tissue flap techniques using a woman's own abdominal, back, or thigh tissue, the reconstructed breast does carry the same breast cancer risks and predispositions as the rest of the body. However, these flaps do not increase the risk of recurrence above what already exists. The main concern is monitoring the flaps closely since any developing tumors may be obscured within them compared to natural breast tissue.

For all reconstruction types, routine screening and self-exams remain critical for early recurrence detection. While reconstruction does not increase your risk of getting cancer again, many people still have a genetic risk of developing cancer and should routinely monitor their symptoms. Your doctors can help with determining and managing your follow-up care and risk profile.

The risk of breast cancer reoccurrence after reconstruction is dependent upon the stage of the initial breast cancer. Higher stages of cancer and larger tumors pose a greater risk. Triple-negative cancers lacking ER, PR, and HER2 have a higher chance of recurrence, around 25-30% after five years. Inflammatory breast cancer also has a high recurrence rate, nearing 40% after five years, due to its aggressive nature. 

The risk of a recurrence is not dependent on the chosen reconstruction method. Lumpectomies and mastectomies are both safe and effective options for removing cancerous cells.

How to Check for Breast Cancer Following Reconstruction

Patients are recommended to follow up with their breast oncologist, medical oncologist, and plastic surgeons on a regular basis to monitor for the risk of recurrence. If the patient has had a mastectomy with reconstruction, annual screening with mammography and ultrasound is not necessary. A physical exam is a reliable method of monitoring after a mastectomy to check for any signs of recurrence. If the patient underwent a lumpectomy with oncoplastic reconstruction, annual screening is still required, along with a physical examination.

Interested in learning more about breast reconstruction after a mastectomy?

Meet Our Top-Rated Breast Physicians: Expert Care for Breast Health

At The Institute for Advanced Reconstruction, our team of highly-skilled surgeons stand by our patients throughout their entire breast cancer journey from the initial diagnosis to post-operative care. Dr. Eric Chang is an award-winning plastic and reconstructive surgeon with specialized training in the most  advanced methods of breast reconstruction. Schedule a consultation with Dr. Chang today to learn more about your options for breast reconstruction. 

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