Navigation Links
Breast Reconstruction After Mastectomy: Now or Later?
Date:9/20/2010

By Kathleen Doheny
HealthDay Reporter

MONDAY, Sept. 20 (HealthDay News) -- Two new studies may help breast cancer patients and their doctors make treatment decisions involving immediate breast reconstruction after mastectomy.

One study finds that about half of women who need radiation therapy after having had a mastectomy with immediate reconstruction develop complications that require additional surgery. Another study finds that chemotherapy does not affect complication rates after mastectomy and immediate reconstruction.

Both reports are published in the September issue of the Archives of Surgery.

The growing trend toward immediate reconstruction "has turned into a runaway train," said researcher Dr. Rodney Pommier, professor of surgery at Knight Cancer Institute, Oregon Health & Science University in Portland. Some women, he said, would be better off delaying it.

Pommier and his colleagues evaluated 302 women who had mastectomies; of these, 152 had reconstruction, including 131 immediately, and 100 had radiation after the mastectomy.

Among those 100 who needed radiation, complications occurred in 44 percent of those who had immediate reconstruction, but only in 7 percent of those who did not have immediate reconstruction.

Both scenarios -- having radiation after mastectomy and having reconstruction done immediately -- strongly predicted the risk of complications, Pommier's team found. Radiation tripled the risk, and immediate reconstruction increased the risk eightfold.

Implants had to be removed in 31 percent of patients who had radiation after mastectomy, compared to just 6 percent of those who did not have to have radiation, the researchers reported.

"We were surprised that one in three lost implants," he said. His team was also surprised at the complication rates overall. "I think it was known that complication rates [among those who need radiation] are fairly high, but I don't think they have been quantified," he noted.

The results, Pommier said, have changed his thinking. He now suggests that having a biopsy of the sentinel lymph node (the first to receive drainage from a tumor) before deciding whether to have immediate reconstruction would be wise. "If the sentinel node is negative, there is a low probability they would get radiation," he explained.

This biopsy is typically done at the start of the mastectomy, he said. But it can be done as a 30-minute outpatient procedure before the mastectomy is scheduled and before the reconstruction decision is made. In determining who will need radiation after mastectomy, doctors consider biopsy results as well as other factors, such as tumor size.

In the second study, researchers from the University of California, San Francisco, found that chemotherapy, either before or after the mastectomy and immediate reconstruction, had no bearing on complications and the need for more procedures.

Overall, 31 percent of 163 patients studied (some of whom received chemo, and some who did not) had a complication that required a return trip to the operating room. But the rate didn't differ based on whether the woman received chemo before surgery, after, or not at all.

The two new studies are putting some numbers behind what doctors have observed in patients, said Dr. Joanne Mortimer, director of the women's cancer program at City of Hope Comprehensive Cancer Center in Duarte, Calif., who reviewed the findings.

"I think they actually put in writing what physicians have appreciated clinically," she said.

While immediate reconstruction can help a woman cope psychologically, Mortimer said, sometimes it is not best in the long run if a woman needs radiation.

More information

For more on breast reconstruction after mastectomy, visit the American Cancer Society.

SOURCES: Joanne Mortimer, M.D., director, women's cancer program, and vice-chair, medical oncology, City of Hope Comprehensive Cancer Center, Duarte, Calif.; Rodney Pommier, M.D., professor of surgery, Oregon Health & Science University, Knight Cancer Institute, Portland, Ore.; September 2010, Archives of Surgery


'/>"/>
Copyright©2010 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Paxil Blocks Tamoxifen, Lowers Survival Odds Against Breast Cancer
2. Low forms of cyclin E reduce breast cancer drugs effectiveness
3. Racial disparities persist in the diagnosis of advanced breast cancer and colon cancer in the U.S.
4. For Some Breast Cancer Patients, Shorter Radiation Works Well
5. Short-term radiation therapy successful on breast cancer
6. Few Women at High Risk for Breast Cancer Take Tamoxifen
7. Hormone May Prevent Aggressive Breast Cancer
8. MSU researcher linking breast cancer patients with alternative therapies
9. MRI May Not Add Value to Routine Breast Cancer Care
10. Breast Cancer Stats Differ Racially Despite Similar Mammogram Rates
11. Businesses Rally Big Efforts to Benefit the Susan G. Komen Phoenix Affiliates Fight Against Breast Cancer
Post Your Comments:
*Name:
*Comment:
*Email:
Related Image:
Breast Reconstruction After Mastectomy: Now or Later?
(Date:10/13/2017)... ... October 13, 2017 , ... While it’s often important to take certain medications ... from Austin, Texas, has identified a solution. , She developed a prototype for MOTION ... As such, it eliminates the need to turn on a light when taking medication ...
(Date:10/13/2017)... ... , ... Lori R. Somekh, founder of the Law Office of Somekh ... law and special needs planning attorneys. “Membership in ElderCounsel helps our office remain up ... network with elder law attorneys nationwide,” said Somekh. , ElderCounsel was ...
(Date:10/13/2017)... ... ... Global Healthcare Management’s 4th Annual Kids Fun Run brought out many kids this ... by Global Healthcare Management’s CEO, Jon Letko, is aimed at getting kids excited about ... ages; it is a non-competitive, non-timed event, which is all about having fun and ...
(Date:10/13/2017)... ... October 13, 2017 , ... “America On The Brink”: the Christian history of ... Brink” is the creation of published author, William Nowers. Captain Nowers and his ... veteran, he spent thirty years in the Navy. Following his career as a ...
(Date:10/12/2017)... (PRWEB) , ... October 12, 2017 , ... IsoComforter, Inc. ... products, announced today the introduction of an innovative new design of the shoulder pad. ... so you get maximum comfort while controlling your pain while using cold therapy. By ...
Breaking Medicine News(10 mins):
(Date:10/2/2017)... , Oct. 2, 2017  Eli Lilly and Company ... results for the third quarter of 2017 on Tuesday, ... call on that day with the investment community and ... The conference call will begin at 9 a.m. ... access a live webcast of the conference call through ...
(Date:9/28/2017)... Hill-Rom Holdings, Inc. (NYSE: HRC), will host ... webcast on Friday, November 3, 2017, beginning at 7:00 ... approximately 8:30 a.m. (CDT) / 9:30 a.m. (EDT). ... performance and guidance for 2018, Hill-Rom executives will also ... performance, and long-range financial outlook through 2020. ...
(Date:9/25/2017)... --  Montrium , an industry leader in powerful ... Trial Master Files & Inspection Readiness Conference ( ... Services has selected eTMF Connect to ... a leading European contract research organization (CRO), will ... enable greater collaboration with sponsors, improve compliance and ...
Breaking Medicine Technology: