

Question: Can I have radiation therapy to the chest area after I have a tissue flap breast reconstruction?

Answer: You can have radiation to a flap, again, just as if someone had radiation to an implant, there is scar tissue that will develop over that flap and under that flap and cause the flap to not be as soft. So if we know someone's going to get radiation, sometimes we will delay reconstruction, so that we can bring in that healthy tissue that hasn't experienced the radiation.

If we don't know -- often nowadays, we don't realize that someone is going to need post-mastectomy radiation. The criteria has typically been a breast cancer that's bigger than five centimeters, or more than four positive lymph nodes. But if you don't know that going into your mastectomy, and then the team is surprised post-operatively that there are multiple positive lymph nodes, and you've already had your reconstruction, then yes, you're going to get radiation. And we do it, and we see how the outcome fares. If the outcome is not good down the road, then we fix the reconstruction or replace it with another one. There certainly is nothing that says you can't have the radiation; you must have the radiation if it is recommended for your cancer. And then the reconstruction may, again, not fare well and just has to be fixed.

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