Adjuvant therapies – chemotherapy, radiotherapy and hormonal therapy – may still be needed after a breast reconstruction. It all depends on what stage the cancer is at and how extensive it is. Different adjuvant therapies affect a breast reconstruction in different ways, and in some cases not at all.
Chemotherapy has no known direct effect on the reconstructed breast. However, the reconstructive procedures can sometimes delay a course of chemotherapy if there are complications after surgery.
Effects of Radiotherapy on Immediate Reconstruction
In quite a high number of cases (up to 50%), radiation leads to capsular contracture in implant-based breast reconstructions. This is when excessive or invasive scar tissue forms around the implant. The scar tissue contracts as part of the healing process, causing the reconstructed breast to harden and change its shape. This normally happens in the early years after surgery, but sometimes it can happen many years down the line. Capsular contracture can be uncomfortable and in some cases, the implant and the capsule may need to be removed.
The effect of radiotherapy on Own Tissue Reconstruction is much less important. If radiotherapy is anticipated, an Own Tissue Reconstruction might therefore be a better option. However, this is an ongoing medical debate, and opinions differ betweeen surgeons and across centres.
Effects of Radiotherapy on Delayed Reconstruction
Previous radiotherapy to the breast may affect your options for Delayed Reconstruction. Reconstruction using an Expander-Implant is unsuitable in these cases as skin that has been irradiated cannot be expanded like normal skin. This results in a high risk of wound breakdown, infection and capsular contracture. An Own Tissue Delayed Reconstruction may therefore be a more suitable option.
Hormonal therapy has no known adverse effects on breast reconstruction.