Tissue Expansion for Breast Reconstruction Can Be Challenging In Women With Previous Radiation Therapy
Though radiation therapy is important in many situations for the treatment of breast cancer, it does present a challenge for breast reconstruction. Its permanent effects on the tissues of the chest can be significant and will have some impact on the reconstructive results.
The ionizing radiation injures and destroys healthy cells leading to scarring, thickening and rigidity of the tissues often with some associated change of color and texture. The outcome is skin and underlying tissues that feel firm, somewhat rigid and more resistant to stretching which is required for breast reconstruction using tissue expansion. In addition, nutritional blood flow to the area exposed to the radiation is significantly decreased due to permanently injured blood vessels. The consequences of this are an increased risk of infection, prolonged healing times from surgery and injury and greater susceptibility to trauma.
Because of these manifestations of radiation, it is not uncommon to be unable to stretch the tissue out to the predetermined volume and it definitely requires more time and patience. Infections are more common as is the incidence of capsular contracture, the formation of additional restricting scar tissue that further limits expansion. Incisions take much longer to heal and may reopen during the expansion. The tissue expanders not infrequently erode through the skin requiring an immediate surgical response.
Breast reconstruction employing tissue expanders in previously irradiated tissue can be successful but the risks and challenges should be understood as well as other options that may be available.
If you would like additional information on breast reconstruction or any other surgical procedure or to schedule a consultation, you can contact my office at 480-451-3000.
Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona