ABSTRACT
Breast cancer patients must make important decisions regarding whether or not to undergo
breast reconstruction as well as what kind of reconstruction is best for them. A number
of options for reconstruction are available, including saline or silicone prostheses,
autologous transverse rectus abdominis muscle (TRAM) flaps, and autologous, muscle-sparing
deep inferior epigastric perforator (DIEP) flaps. Even more difficult, however, is
the decision if and when adjuvant radiation should be administered. The timing of
radiation therapy can significantly affect the breast's final cosmetic and structural
outcome. This article summarizes existing studies on how outcome is affected, with
the conclusion that no reconstructive techniques are impervious to the damaging effects
of postoperative radiation. However, there are numerous psychologic and economic benefits
associated with immediate reconstruction. Depriving patients of these benefits is
unnecessary when the likelihood of cancer recurrence is low. Together, surgeons, oncologists,
and patients must first decide whether radiation is appropriate. Then they must assess
the proper timing for its administration to achieve an outcome that is not only free
of disease but also cosmetically acceptable.
KEYWORD
Radiation - breast reconstruction - review
