The Effects of Radiation in Reconstructed Breasts

Immediate breast reconstruction following mastectomy has become an increasingly popular and
accepted treatment option among breast cancer patients. This change in practice has resulted
in a significant number of patients who undergo radiation therapy after breast
reconstruction. Following irradiation, the reconstructed breast often experiences fibrotic
contracture, volume loss, altered pigmentation, or some combination thereof, producing an
asymmetric and aesthetically compromised result. The effects of radiation on reconstructed
breasts as well as the implications that such changes have for timing of reconstructive
surgery, post-operative management and surveillance imaging are topics of growing importance
in plastic surgery, radiology and surgical oncology.

Inclusion Criteria:

- Female patients between 18 and 90 years of age.

- Patients with a diagnosis of unilateral breast cancer who elect to undergo bilateral
mastectomy with immediate free flap reconstruction.

- Patients must also have a locally advanced tumor that requires adjuvant radiation
therapy following reconstruction.

Exclusion Criteria:

- Women who do not undergo immediate, bilateral breast reconstruction using a free
flap.

- Women who do not require unilateral, adjuvant radiation therapy

- Women who are pregnant

- Women who have altered renal function, defined as a personal history of diabetic,
hypertensive or autoimmune nephropathy and/or on routine preoperative testing are
found to have a serum creatinine greater than or equal to 1.3