Radiation after Mastectomy with Reconstruction
Dear OncoLink "Ask The Experts,"
I had a left-sided mastectomy with immediate reconstruction and tissue expander. I had DCIS with invasion and had a sentinel lymph node biopsy, which came back with 2 positive nodes out of 11. I'm undergoing chemo with A/C and Taxol for a total of 8 treatments, and my oncologist recommended radiation when I'm finished. I'm wondering what the radiation will do to the completion of the reconstruction with the tissue expander that is in place?
Lawrence J. Solin, MD, FACR, Professor of Radiation Oncology at the University of Pennsylvania, responds:
Some patients will benefit from radiation treatment after mastectomy. This form of radiation treatment is typically referred to as post-mastectomy radiation treatment (PMRT). Patients with positive axillary lymph nodes will often benefit from PMRT. Such treatment reduces the risk of local-regional recurrence, and may also be associated with a small improvement in overall survival.
Radiation treatment can be technically delivered without any difficulty when a breast reconstruction has been performed. The radiation treatment is equally as effective as when there is no reconstruction. However, there may be a small increase in the risk of complications from the reconstruction when radiation is added. The type and risk of complications varies according to the type of reconstruction, and is best discussed with your plastic (reconstructive) surgeon and radiation oncologist.
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