Radiotherapy and reconstruction

[Samct]

I had a tissue expander inserted after a skin-sparing mastectomy (3.5cm lump, stage 2, grade 2, clear sentinel nodes) in January. I've had 4 months of chemotherapy and was due to start 5 weeks of radiotherapy, as the tumor was close to the chest wall. However, the port of my tissue expander has shifted and is the path of the planned radiation. My oncologist thinks the metal in the beam path is a problem, and that replacement of the tissue expander with a permanent implant should be done before radiation. My mastectomy scar has healed well. I'm 34 years old. I'd appreciate any thoughts on the advisability of completing the reconstruction before radiotherapy.

[Poodah]

i am having trouble with my new (investigational) tissue expanders.  the valves are killing me and they didn't work because of radiation done the first time i had cancer.  my new plastic surgeon is replacing them with an implant that is tear-drop shaped.  the "valve" is at the top and is flat (flush) with the implant.  this saves that horrible pain from the lump under both arms.  that is IF i don't have cancer again . . . i had to have a skin biopsy done yesterday.  i guess if it's back, i will have to have them removed altogether.  i think i am trying to reject them.  battle after battle . . . good luck.

[CCF-RN,MSN-rf]

Dear Samct:  Different people have different reactions to radiation therapy.  This may or may not cause you any problem.  Our advice is to seek the expertise of a plastic surgeon who is well familiar with post mastectomy reconstruction and have a conversation about your particular situation.  The radiation oncologist, medical oncologist and plastic surgeon would, optimally, work together to give you the best possible outcome.