Hawaii medical journal
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Hawaii medical journal · Apr 2009
Selection criteria for expander/implant breast reconstruction following radiation therapy.
Breast reconstruction with expander/implants is generally discouraged in patients who have undergone radiation therapy. However, not every patient treated with radiation develops sequelae severe enough to preclude the use of prostheses. To date, there have been no studies that have established criteria for selecting which patients may still be considered for expander/implant reconstruction. We present a series of 27 patients--the largest of its kind to date--all of whom underwent bilateral mastectomies, radiation therapy to only one chest wall, and delayed reconstruction with submuscular expander/implants. The aesthetic outcomes of the irradiated and the non-irradiated breasts were compared, and a classification of post-radiation skin changes was devised for selecting candidates for expander/implant reconstruction. ⋯ A history of chest wall radiation should not itself exclude patients from receiving expander/implant reconstruction. Patients who develop neither severe skin changes nor induration may still be considered for prostheses.