Radiation therapy uses high energy rays to kill cancer cells. It may be used after surgery to destroy any remaining tumor cells in order to reduce the chance that the cancer will recur. Normal cells in the breast are also affected by the radiation. This change is permanent and affects skin elasticity and the ability of the tissues to heal. These changes make implant based reconstruction especially challenging and predispose the implant to complications like infection, wound healing problems, and capsular contracture. Therefore, for most women who were treated with radiation, some form of natural tissue reconstruction is generally considered the best option.
In cases where it is known or there is a high likelihood that radiation therapy will be required, it is prudent to delay any natural tissue reconstruction until after the completion of radiation therapy. This avoids radiation damage to your natural tissue reconstruction. For women who know that a natural tissue reconstruction is their goal, a “delayed-immediate breast reconstruction” approach can be used. In these cases a tissue expander is placed at the time of the mastectomy so it bears the brunt of radiation treatments while preserving the breast skin surface area. In a second stage procedure the tissue expander is removed and replaced with your natural tissue. This creates a breast, which has the appearance of an immediate reconstruction but does not have the negative effects of radiation therapy.
Chemotherapy drugs are often used to treat breast cancer either before or after surgery. Normal cells that are responsible for healing in the breast are also affected by chemotherapy. These changes are temporary and with proper planning breast reconstruction can safely be performed after your immune system has had time to recuperate after chemotherapy.
Tamoxifen and Arimidex are commonly used hormone therapy agents to treat breast cancer. Hormone therapy does not affect whether or not you are a candidate for breast reconstruction.
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