Skip to main content
Journal of the National Medical Association logoLink to Journal of the National Medical Association
. 1994 Jul;86(7):538–542.

Postoperative irradiation following immediate breast reconstruction using a temporary tissue expander.

W B Jackson 1, A L Goldson 1, C Staud 1
PMCID: PMC2607601  PMID: 8064906

Abstract

Ten consecutive patients at Howard University Hospital underwent modified radical mastectomy with immediate breast reconstruction using a temporary tissue expander. Postoperative irradiation was delivered to the breast mound encompassing the tissue expander. The effects of expansion on the delivery of postoperative irradiation was assessed. Dosimetric measurements with thermoluminescent dosimeters revealed that the saline-filled expander attenuated the photon beam 3% less than tissue-equivalent material of equal volume. This dose variation was negligible, so no adjustments were made. Postoperative treatment consisted of 5040 cGy to 5220 cGy delivered in 5 to 10 weeks using 4 mV photon tangentials. Cosmesis was assessed over a 2-year period. Six patients completed reconstruction and irradiation without complications. Cosmesis was good in five and fair in one. One patient developed a moist reaction secondary to postoperative irradiation; however, final cosmesis was good. Three patients developed complications leading to the loss of the reconstructed breast. Successful final reconstruction can be achieved with careful patient selection and close follow-up by the plastic surgeon and radiation oncologist.

Full text

PDF
538

Images in this article

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Chisholm E. M., Marr S., Macfie J., Broughton A. C., Brennan T. G. Post-mastectomy breast reconstruction using the inflatable tissue expander. Br J Surg. 1986 Oct;73(10):817–820. doi: 10.1002/bjs.1800731019. [DOI] [PubMed] [Google Scholar]
  2. Dick G. O., Brown S. A. Breast reconstruction using modified tissue expansion. Plast Reconstr Surg. 1986 Apr;77(4):613–620. doi: 10.1097/00006534-198604000-00017. [DOI] [PubMed] [Google Scholar]
  3. Drever J. M., Hodson-Walker N. Closure of the donor defect for breast reconstruction with rectus abdominis myocutaneous flaps. Plast Reconstr Surg. 1985 Oct;76(4):558–565. doi: 10.1097/00006534-198510000-00013. [DOI] [PubMed] [Google Scholar]
  4. Fisher B., Bauer M., Margolese R., Poisson R., Pilch Y., Redmond C., Fisher E., Wolmark N., Deutsch M., Montague E. Five-year results of a randomized clinical trial comparing total mastectomy and segmental mastectomy with or without radiation in the treatment of breast cancer. N Engl J Med. 1985 Mar 14;312(11):665–673. doi: 10.1056/NEJM198503143121101. [DOI] [PubMed] [Google Scholar]
  5. Hokin J. A., Silfverskiold K. L. Breast reconstruction without an implant: results and complications using an extended latissimus dorsi flap. Plast Reconstr Surg. 1987 Jan;79(1):58–66. [PubMed] [Google Scholar]
  6. Jacobson G. M., Sause W. T., Thomson J. W., Plenk H. P. Breast irradiation following silicone gel implants. Int J Radiat Oncol Biol Phys. 1986 May;12(5):835–838. doi: 10.1016/0360-3016(86)90044-1. [DOI] [PubMed] [Google Scholar]
  7. Krishnan L., Krishnan E. C. Electron beam irradiation after reconstruction with silicone gel implant in breast cancer. Am J Clin Oncol. 1986 Jun;9(3):223–226. doi: 10.1097/00000421-198606000-00010. [DOI] [PubMed] [Google Scholar]
  8. Lapin R., Elliott M., Juri H. The use of an integral tissue expander for primary breast reconstruction. Aesthetic Plast Surg. 1985;9(3):221–226. doi: 10.1007/BF01570854. [DOI] [PubMed] [Google Scholar]
  9. Mansfield C. Effects of radiation therapy on wound healing after mastectomy. Clin Plast Surg. 1979 Jan;6(1):19–26. [PubMed] [Google Scholar]
  10. Manstein C. H., Manstein G., Somers R. G., Barwick W. J. Use of pectoralis minor muscle in immediate reconstruction of the breast. Plast Reconstr Surg. 1985 Oct;76(4):566–569. doi: 10.1097/00006534-198510000-00015. [DOI] [PubMed] [Google Scholar]
  11. Mendelson B. C. Latissimus dorsi breast reconstruction--refinement and results. Br J Surg. 1983 Mar;70(3):145–149. doi: 10.1002/bjs.1800700304. [DOI] [PubMed] [Google Scholar]
  12. Radovan C. Breast reconstruction after mastectomy using the temporary expander. Plast Reconstr Surg. 1982 Feb;69(2):195–208. doi: 10.1097/00006534-198202000-00001. [DOI] [PubMed] [Google Scholar]
  13. Schover L. R. The impact of breast cancer on sexuality, body image, and intimate relationships. CA Cancer J Clin. 1991 Mar-Apr;41(2):112–120. doi: 10.3322/canjclin.41.2.112. [DOI] [PubMed] [Google Scholar]
  14. Wellisch D. K., Schain W. S., Noone R. B., Little J. W., 3rd Psychosocial correlates of immediate versus delayed reconstruction of the breast. Plast Reconstr Surg. 1985 Nov;76(5):713–718. doi: 10.1097/00006534-198511000-00010. [DOI] [PubMed] [Google Scholar]

Articles from Journal of the National Medical Association are provided here courtesy of National Medical Association

RESOURCES