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Radiation After Breast Reconstruction Ups Capsule Risk

Radiotherapy triples the risk of capsule formation after immediate breast reconstruction

FRIDAY, Oct. 27 (HealthDay News) -- After immediate breast reconstruction, capsule formation is three times more likely in breast cancer patients who undergo radiotherapy, according to the results of a study published in the October issue of the Journal of Plastic, Reconstructive & Aesthetic Surgery.

Kasim Behranwala, M.D., of the Royal Marsden NHS Foundation Trust in London, U.K., and colleagues conducted a study of 114 women who underwent 136 breast reconstructions over a median of four years.

Of the 44 reconstructed breasts that received radiotherapy, 17 (38.6 percent) developed capsules compared to 13 (14.1 percent) of the reconstructed breasts that did not receive radiotherapy. In patients with capsules, the researchers identified significant differences in geometric measurements of symmetry. They also found that eight of the 30 patients with capsules experienced persistent pain two years or more after surgery compared to only one of the 106 patients with no capsules.

"As the majority of reconstructions who had radiotherapy in this study did not develop a clinical capsule, an implant-assisted immediate breast reconstruction is still a viable option in appropriate cases," the authors conclude. "However, with significantly increased capsule formation rates following radiotherapy, our unit policy remains to recommend delayed breast reconstruction in those likely to need radiotherapy, offering an implant-assisted immediate reconstruction only in those who accept no other option after informed consideration of their choices."

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