Expnders and radiation

[traceyz]

I am having a bilateral mastectomy with immidiate reconstruction (expanders). I have been told by my plastic surgeon that this would not be a problem, because any problems that MAY arise due to rads could be fixed. I was also told by my (2nd opinion) breast oncology surgeon that rads dont ALWAYS jack up the implant. However my oncology surgeon is VERY against immediate recon when rads are involved. He thinks I should wait up to a year. I REALLY want immediate recon because I am only 41 and waiting up to 12mos is not something I want to do. I see my radiation oncologist next week and I am sure they will agree with the surgeon about waiting because they are all on the same team. However I spoke to another radiation oncologist who said they radiate with expanders all the time and sometimes there are problems but for the most part it's fine. Im confused!!!!!!!!!!!!!! Please Help

[PaulMD]

Hi.

The decision whether to have immediate or delayed reconstruction would depend primarily on your preference.  Immediate reconstruction carries the risk of expander problems in a minority of cases (about less than 5% - 10%of patients), while the rest are OK.  Radiated expander problems would include hardening, limitation of expansion, and stiffening of the surrounding tissues.  This can have an effect in the final appearance and size of the breast.  If this 5-10% risk is too high for you, then you can opt for delayed reconstruction.  

You can also ask your doctors regarding the actual percentage risks, as these figures are only my estimate.

Regards.

[traceyz]

Thanks so much for you response. I went to get a second opinion and she said the exact same thing you said. She actually said its better to do immediate because after radiation the skin does not stretch. So that is what I am gonna do.

Again thanks!!!