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Reconstruction Years after Therapy

Reconstruction Years after Therapy

Question

Dear OncoLink "Ask The Experts,"

Is it too late to get breast reconstruction after a 1986 lumpectomy with radiation? I have neck pain [that] I think is from scarring from the cancer treatment. I have had the acute pain for over a year and want some solutions. I have had hyperbaric treatment and some medications to lessen the scarring, but both are risky according to my doctor.

Answer

Don LaRossa, MD, Professor of Surgery at the University of Pennsylvania Medical School, responds:

There seem to be two questions here. You are still a candidate after treatment in 1986 unless there are other complicating factors. In the past, breast reconstruction was delayed for months or years after mastectomy because some physicians felt that it increased post-operative complications. This in turn would lead to a longer post-operative recovery period and a delay in the start of adjuvant therapy (chemotherapy or radiation). Studies have since proved that this is not true, and now immediate reconstruction is commonplace.

The second concern relates to pain and scarring from the original treatment. It is very unlikely that the pain you are having would be improved by breast reconstruction. A consultation with a pain specialist might be of considerable help in dealing with the pain. Hyperbaric oxygen therapy is a treatment that uses increased air pressure and high concentrations of oxygen to help heal wounds, infections, burns, and problems with skin grafts. It has complications related to the pressure, such as ear, tooth, and sinus pain and/or bleeding, abdominal pressure, dizziness, hearing loss, and collapsed lung. Furthermore, I do not know if it is effective in scars that are older, such as yours.