How Do Chemotherapy and Radiation Affect Breast Reconstruction?

February 8th, 2017

breast reconstruction northern virginiaOften, my Fairfax and Northern Virginia-area patients will have chemotherapy or radiation therapy in addition to a mastectomy or lumpectomy procedure. Because of how these therapies work, their effects on the breast tissue, and their timing, I will generally plan breast reconstruction surgery around the treatments. Learn more about why and how.

Chemotherapy

Chemotherapy typically follows a cyclical schedule with a period of recovery between each treatment. Similarly, some of my Northern Virginia / Fairfax patients require multiple breast reconstruction procedures to get the results that they want, such as adjustments to the implant or nipple reconstruction. Depending on your situation:

  • You may need to start chemotherapy after you have begun the breast reconstruction process. In this case, I will delay reconstructive procedures until your chemotherapy is finished.
  • If you have already completed chemotherapy, the timing of your breast reconstruction surgeries is flexible, and we can schedule according to your preferences.

Radiation Therapy

Radiation therapy can usually begin as soon as you recover from your mastectomy or lumpectomy. When you start radiation therapy, you will not be able to have a breast reconstruction procedure until six months after the radiation is complete.

Why? The tissue that is being irradiated needs time to recover.  The radiated skin cannot heal itself from surgery until the acute radiation damage is healed, so a 6 month wait between radiation and surgery is a minimum.  This will allow your body to heal properly following breast reconstruction surgery.

Unsure Whether You Will Have Chemotherapy?

My Northern Virginia / Fairfax breast reconstruction patients are sometimes uncertain when or whether they will receive chemotherapy. In these cases, I can recommend options with flexibility to suit their needs.

There are different approaches to breast reconstruction. Many allow us to “pause” the process until you have received chemotherapy. Reconstruction has no health ultimatum or time constraint, so coordinating your schedule is done based on safety to you, timing for the best outcome, and convenience as you juggle your family, job, and life with the demands of breast cancer.

Unsure Whether You Will Have Radiation?

Some people who are having a mastectomy don’t know whether they are receiving radiation until after their surgery. Here is the general approach I recommend:

  • I encourage patients to have a breast implant placed at the time of their mastectomy. This lets them wake up with a reconstructed breast and to conserve as much skin as possible.
  • If the patient doesn’t receive radiation, she can choose to keep the implant. She may also choose to have a follow-up breast reconstruction procedure to replace the implant with natural tissue.
  • If the patient does receive radiation, I advise her to have natural tissue transferred to the breast six months after radiation therapy is complete.

This case—transferring natural tissue after radiation—takes some explaining. Long-term, tissue that has been irradiated does not tolerate a breast implant as well as normal tissue. It can cause capsular contracture and results that do not look natural and attractive.

After a patient has completed radiation, we can move healthy, non-irradiated tissue to the area of the surgery. This can reverse some of the local damage that the radiation caused without affecting the treatment’s therapeutic effects.
Whether or not you are receiving radiation or chemotherapy, Dr. Jespersen can plan an approach to breast reconstruction that meets your needs. Fairfax-area patients can schedule a consultation by calling (703) 992-7969 or completing our contact form.

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