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Implant Breast Reconstruction Offers Hope to Patients who Receive Radiation Therapy
Recently, there has been much debate in the medical community about performing implant breast reconstruction in women who have had radiation therapy. Some plastic surgeons believe breast reconstruction should not be performed at all in this population. Jeffrey A. Ascherman, MD, Assistant Professor of Surgery at Columbia and Site Chief, Division of Plastic Surgery at Columbia University Medical Center, disagrees. In a recent clinical review, Dr. Ascherman and his research team evaluated implant breast reconstruction in patients who received radiation prior to or following surgery for breast cancer. The review specifically looked at his patients who underwent breast reconstruction after mastectomy for breast cancer from 1996 to 2003.
"We looked at 108 of my patients who underwent mastectomy and implant breast reconstruction, and out of this group 31 patients received radiation therapy. We compared the two groups to see the difference in results. While we did find increased challenges in those that underwent implant reconstruction after radiation therapy, our review showed an acceptable risk-factor. In addition, we found fewer complications in our radiated patients who underwent implant reconstruction when we compared our results to those published elsewhere," reports Dr. Ascherman.
Dr. Ascherman believes the benefits of the operation greatly outweigh the risks. "I believe women who have been radiated can have implants, and we have the numbers to prove it. Many of these breast cancer patients face the choice of having no breast and being flat-chested the rest of their life or opting for an implant. I think it is certainly worthwhile that they should have the choice to try reconstruction. They should be aware that there are risks that are more common since they had radiation, but these risks are not so high."
Possible risks include infection, the chance that an implant may erode through the overlying skin, and a longer healing process. Dr. Ascherman adds, "Risks exist in any implant surgery, including in women who never had radiation. The risks are just increased in the radiated population. Normally, the very worst that can happen is that you have to take out the implant. The risks are not life-threatening and dangerous-I think this is an important point of distinction, and this is why I believe it is worthwhile to consider this procedure as a viable option. Most of all, we can offer these women hope. If we didn't perform the procedure at all, there would be no chance of that."
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