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Breast reconstruction after lumpectomy and radiation treatment

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Lawrence J. Solin, MD, FACR
Last Modified: December 23, 2001

Dear OncoLink "Ask the Experts,"
It has been a year since I received 25 radiation treatments for Stage II Breast Cancer. Though I had a lumpectomy, I would like to reconstruct the breast to make it look more symmetrical. The plastic surgeon feels that a standard breast lift should fix the problem, but I would like to use a submuscular saline implant as well. Are my chances really that much worse to get capsular contracture (because of the previous radiation) than a patient with a non-radiated breast? What other complications may arise because of my radiation therapy if I choose to reconstruct?

Lawrence J. Solin, MD, FACR, Professor of Radiation Oncology at the University of Pennsylvania, responds:

After lumpectomy and radiation treatment, reconstruction of the treated breast is generally not recommended for a number of reasons. Detection of a local recurrence becomes more difficult. Screening for local recurrence is done with mammography, breast self-examination, and physical examination by a physician, and all of these are more difficult after reconstruction. Screening for local recurrence is important after breast conservation treatment because local recurrence is a potentially treatable and curable event. Finally, the risk of complications from plastic surgical reconstruction rises after radiation treatment.

One potential alternative is to reconstruct the opposite breast to attempt to better match the radiated breast. You might contact your plastic surgeon to see if this is feasible.