Good News for Breast Cancer Patients

Radiation following reconstruction has low complication rates, new study says

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WEDNESDAY, Oct. 22, 2003 (HealthDayNews) -- Breast cancer patients who've had a mastectomy experience low complication rates when they have breast reconstruction before radiation, says a Fox Chase Cancer Center study.

"Prior studies have shown a high rate of complications among breast cancer patients who undergo reconstruction and then post-mastectomy radiation therapy," Fox Chase radiation oncologist Dr. Penny R. Anderson says in a prepared statement.

"Anecdotally speaking, we weren't seeing major complications regularly at Fox Chase, and that observation became the impetus for this study," Anderson says.

She and her colleagues studied 85 breast cancer patients, median age 45, who had a modified radical mastectomy, breast reconstruction and post-operative radiation therapy between 1987 and 2002.

Reconstruction consisted of tissue expander placement with or without a subsequent permanent implant in 50 patients. In the other 35 patients, reconstruction consisted of an autologous transverse rectus abdominis myocutaneous (TRAM) flap.

Seventy of the patients received radiation therapy after they had their mastectomy and reconstruction. The median time from reconstruction to radiation therapy was seven months. Fifteen patients received radiation therapy before their reconstruction.

After five years of follow-up, none of the patients who received a TRAM flap had major complications or required any corrective surgery. Among those who received implants, 5 percent had major complications and two of the patients required removal of the implant.

Major complications were defined as problems that required corrective surgery or loss of reconstruction.

Over the same period, 39 percent of the TRAM group had minor complications, compared with 14 percent of those in the implant group. Minor complications included infection, chest wall fibrosis, fat necrosis or contracture.

"What's interesting about this reported complication rate for breast implants is that not only is it low compared to other studies involving radiation after reconstruction, it is also low when considering the rate of major complications following reconstruction when radiation is not a factor," Anderson says.

The study was presented Oct. 22 at the annual meeting of the American Society for Therapeutic Radiology and Oncology in Salt Lake City.

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SOURCE: Fox Chase Cancer Center, news release, Oct. 21, 2003

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