A study in the September issue of the Archives of Surgery found that approximately half of women who need radiation therapy after having a mastectomy with immediate breast reconstruction develop complications that require additional surgery.
The trend toward immediate reconstruction “has turned into a runaway train,” said researcher Dr. Rodney Pommier, professor of surgery at Knight Cancer Institute, Oregon Health & Science University in Portland. He says that some women would be better off delaying it.
He and his fellow researchers evaluated 302 women who had mastectomies; of these, 152 had reconstruction, including 131 immediately, and 100 had radiation after the mastectomy.
Of those 100 who needed radiation, complications occurred in 44 percent of those who had immediate breast reconstruction, but only in 7 percent of those who did not have immediate reconstruction.
According to the researchers, having radiation after mastectomy and having reconstruction done immediately strongly predicted the risk of complications. Radiation tripled the risk, and immediate reconstruction increased the risk eightfold.
Implants needed to be removed in 31 percent of patients who had radiation after mastectomy, compared to just 6 percent of those who did not have to have radiation, the researchers reported.
“We were surprised that one in three lost implants,” he said. His team was also surprised at the overall complication rates. “I think it was known that complication rates [among those who need radiation] are fairly high, but I don’t think they have been quantified,” he said.
Implants had to be removed in 31 percent of patients who had radiation after mastectomy, compared to just 6 percent of those who did not have to have radiation, the researchers reported.
The abstract of the study, “Using Complications Associated With Postmastectomy Radiation and Immediate Breast Reconstruction to Improve Surgical Decision Making,” is available online. Learn more about breast reconstruction in Houston, Texas.