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Radiation affects the body in different ways. It targets the nucleus of the cell, making the fast multiplying cancer cells impotent of growth. That is why radiation is the treatment preferred when handling cancer. But radiation also has many side effects. It affects the blood supply to the cells, harming them and making them vulnerable to infections, slow recovery and a host of other problems. With the advance of science, many problems can be solved with different kinds of medicines and therapies and different approaches to the problem. Mastectomy is generally performed when cancer affects and reaches a certain level. Radiation and chemotherapy continue even post operatively. If a breast reconstruction is planned immediately after the mastectomy, and radiation is still advised, it is wiser to wait till the radiation is complete. Radiation results in a significantly greater risk of complications following surgery. These are infection, delayed healing, wound breakdown, fat necrosis, and also implant related problems like capsular contracture and extrusion. In spite of the benefits of radiation therapy, it still can be the source of potential problems especially in the cases of breast reconstruction. The patient should discuss all the points with the doctor and his team. Some solution can be arrived at depending upon the extent of damage by radiation and the possible damage in future. The timing and approach to breast reconstruction can be coordinated to give the best possible result.
Sometimes it is not possible to determine whether the patient needs radiation after mastectomy. And if the process of reconstruction of the breast has already begun then the negative effects of radiation on the reconstructed breast will have to be managed. For those with tissue expanders, radiation may affect the quality of skin on the expander. The skin may recover and the final implant may be done. But if it does not or if other problems arise, then the method of reconstruction may have to be changed. Instead of implant reconstruction the patient can go in for TRAM flap where muscles from the abdomen are used for the reconstruction.
If a woman is undergoing breast reconstruction after many years and she had radiation therapy earlier, it could contribute to poor wound healing and a greater risk of wound infection. It may also cause capsular contracture therefore an autogenous tissue flap such as TRAM procedure can be adopted for breast reconstruction. However all cases are different and each case has to be decided and solved based on its own qualities. |
