Breast cancer patients treated with radiation therapy are at higher risk of complications following implant-based breast reconstruction, according to a new study in the April issue of Plastic and Reconstructive Surgery.
Still, study authors report that reconstruction is eventually successful in 80% of radiation-treated patients despite these complications.
Researchers looked at how radiation affected complication rates in194 breast cancer patients who were undergoing two-stage, implant-based breast reconstruction after mastectomy. About 12% of reconstructions were done on women undergoing radiation therapy before mastectomy, and 6% on women who received radiation after mastectomy. In both radiation groups, the complication rate during reconstruction was more than 40%, compared to 14% for women who did not receive radiation. Smoking also increases the risk of complications after breast reconstruction, the study found.
Specifically, 22% of women undergoing radiation had problems related to wound healing. By contrast, wound complications occurred in less than 2% of women who were not treated with radiation, and only in smokers. With a rate of 19%, problems related to the tissue expander were the second most common complication in the radiation groups. The overall risk of major complications requiring additional surgery was about six times higher in women receiving radiation therapy after controlling for other factors. For smokers, the risk of major complications was more than three times higher, the study showed.
According to the study, the rate of complications leading to repeat surgery for women who have undergone radiation therapy appears "prohibitively high," the study authors conclude. "This information will allow both physicians and patients to make better informed decisions regarding their breast reconstruction procedures," says study author Kant Y. Lin, MD, a plastic surgeon at University of Virginia, Charlottesville in Virginia, in a press release.