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More complications, less satisfaction in breast cancer patients who get radiation, implants

Washington: Many breast cancer patients who have a mastectomy will consider breast reconstruction. But for a portion of these women, radiation therapy is also recommended — and that can alter the tissue around the breast, impacting reconstruction efforts.

Dr Reshma Jagsi, University of Michigan Health System
Dr Reshma Jagsi, University of Michigan Health System

A new study finds that women who have implant reconstruction following radiation therapy had more complications from the surgery and were less satisfied with the result than women who had implants but no radiation.

Patients who received radiation followed by autologous reconstruction, in which flaps of the patient’s own tissue are used to reconstruct the breast, reported complications and satisfaction similar to women who had this reconstruction but did not get radiation.

“Women diagnosed with early-stage breast cancer face challenging decisions that will impact both their long-term disease control and quality of life. These findings have considerable significance for those who have decided to receive post-mastectomy radiotherapy and must select a type of reconstruction,” says study author Reshma Jagsi, professor and deputy chair of radiation oncology at the University of Michigan Medical School.

The study looked at breast cancer patients from 11 institutions who had received mastectomy and reconstruction; 553 also had radiation and 1,461 did not.

Researchers used a number of measures to assess complications within one and two years of treatment as well as patient-reported satisfaction with their breasts.

After two years, 39 percent of patients receiving radiation and implants had at least one complication, and 26 percent of patients receiving radiation and autologous reconstruction did. Among patients who did not have radiation, 22 percent had complications with implants and 28 percent had complications with autologous reconstruction.

Similarly, patients receiving implants and radiation had significantly lower satisfaction than patients who had implants only, while patients who had autologous reconstruction reported similar satisfaction regardless of radiation treatment. Results will be presented at the San Antonio Breast Cancer Symposium.

“Autologous reconstruction is a much more extensive procedure. But given the findings in this study, it may be preferable for some patients, particularly those worried about the impact of radiation on the outcomes of reconstruction,” says Jagsi.

Autologous breast reconstruction uses the woman’s own body tissues (fat and muscle) that are collected from other parts of her body to create a new breast. The reconstructed breast has a more natural feel than a breast implant.

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