Will Breast Reconstruction Affect My Cancer Treatment?

Breast reconstruction can be an important part of the journey for many women after breast cancer treatment. While it aims to help restore the physical appearance and shape of the breasts, potentially improving emotional well-being and quality of life, it is crucial to understand breast reconstruction is an additional surgical procedure with its own set of potential risks and implications. 

Like any surgery, there are chances of complications such as infection, bleeding, or healing issues. Additionally, reconstruction may slightly increase the difficulty of detecting any future cancer recurrence in the affected area. Before making a decision, it is essential to have an open discussion with your healthcare team about the potential benefits and risks involved, as well as how reconstruction may impact your overall cancer treatment plan and follow-up care.

What are the risks and complications associated with breast reconstruction during cancer treatment? 

Like any surgical procedure, breast reconstruction comes with its own set of potential side effects. It is essential for patients to discuss these potential risks thoroughly with their surgical team and weigh them against the potential benefits of breast reconstruction in their specific situation. 

Surgical risks 

Like any major surgery, breast reconstruction carries risks such as bleeding, infection, poor wound healing, and adverse reactions to anesthesia.

Delayed healing

Radiation therapy and chemotherapy can impair the body's ability to heal properly, increasing the risk of wound complications and prolonged recovery.

Implant complications

For implant-based reconstruction, there is a risk of capsular contracture (hardening around the implant), implant rupture or deflation, implant displacement, or an exaggerated immune response.

Flap complications

In autologous tissue reconstruction using flaps, there is a risk of partial or total flap loss due to compromised blood supply, as well as potential donor site complications like abdominal hernias or weakness.

Lymphedema

Breast reconstruction may increase the risk of lymphedema (fluid accumulation) in the affected arm, especially if lymph nodes were removed during cancer treatment.

Impact on cancer detection

Reconstruction can make it more challenging to detect any cancer recurrence through MRI or physical examination of the affected breast.

Interaction with cancer treatment

Reconstruction may need to be delayed or postponed if chemotherapy or radiation is still ongoing, as these treatments can interfere with healing and increase complications.

How long after radiation can you have breast reconstruction?

The timing of breast reconstruction after radiation therapy is an important consideration, as radiation can affect the reconstructive process and long-term outcomes. Typically, it is recommended to wait several months after completing radiation therapy before undergoing breast reconstruction. This allows the radiated tissues to heal and recover from the effects of radiation. The exact timing can vary, but many surgeons suggest waiting at least 6-12 months post-radiation. Attempting reconstruction too soon after radiation increases the risk of complications, such as impaired wound healing, infection, and potential reconstruction failure.

Radiation therapy can also impact the choice of reconstruction method. For patients who plan to have implant-based reconstruction, radiation can increase the risk of capsular contracture (hardening and tightening around the implant) and other implant-related complications. In such cases, autologous tissue reconstruction using the patient's own tissue (such as a DIEP or latissimus dorsi flap) may be a preferred option, as it is less affected by prior radiation exposure.

It is important to note radiation therapy does not necessarily rule out the possibility of breast reconstruction altogether. However, it does require careful planning and consideration of the potential risks and limitations. Close collaboration between the breast surgeon, plastic surgeon, and radiation oncologist is essential to develop the most appropriate reconstruction plan based on the patient's specific circumstances and treatment history.

Does breast reconstruction affect the ability to check for breast cancer recurrence?

Yes, breast reconstruction can potentially affect the ability to check for breast cancer recurrence, though the impact varies depending on the reconstruction method used. With implant-based reconstruction, the implant itself can obscure or make it more difficult to detect abnormalities during physical exams or MRI. Additionally, the presence of scar tissue around the implant can make it harder to distinguish between scar tissue and potentially cancerous masses. Careful positioning and specialized MRI views may be required for adequate screening.

Autologous tissue reconstruction, such as using the patient's own abdominal or back tissue to create the new breast, generally does not interfere with cancer detection as significantly as implants. However, the transferred tissue can still make it more challenging to examine the underlying chest wall and detect any recurrences in that area through physical exams or imaging.

It is important to note breast reconstruction itself does not cause cancer to recur or hide pre-existing tumors. However, the presence of reconstructed breast tissue can potentially mask or delay the detection of new or recurring cancers in certain cases. This is why close follow-up, routine screening MRIs, and physical exams by experienced professionals are crucial for all breast cancer survivors, regardless of whether they have undergone reconstruction.

While breast reconstruction aims to restore the breast's appearance and improve quality of life, it should not compromise the ability to monitor for potential recurrences. Patients should discuss these concerns with their healthcare team and determine the most appropriate screening and follow-up plan based on their individual reconstruction method and cancer history.

Discussing Breast Reconstruction with your Cancer Care Team

If you are a breast cancer survivor considering breast reconstruction or seeking revision of a previous reconstruction, The Institute for Advanced Reconstruction offers unparalleled expertise and compassionate care. Utilizing cutting-edge procedures and technologies, our reconstructive surgeons prioritize your well-being and strive to achieve the best possible surgical outcomes tailored to your unique needs. Schedule a consultation today to take this important step in your healing journey and discuss your surgical reconstruction options.