Nipple-areola reconstruction following chest-wall irradiation for breast cancer: Is it safe?

Lawrence B. Draper, Duc T. Bui, Ernest S. Chiu, Babak J. Mehrara, Andrea L. Pusic, Peter G. Cordeiro, Joseph J. Disa, Alexes Hazen, W. P.Andrew Lee

Research output: Contribution to journalReview article

14 Citations (Scopus)

Abstract

Radiation therapy (RT) is considered by some to be a contraindication to nipple-areola reconstruction (NAR) particularly in patients with breast implant reconstruction. In this retrospective chart review, all patients who underwent breast reconstruction with tissue expanders and implants from 1997-2003 were reviewed. A subset of patients with a history of radiation therapy (pre- or postoperative) was identified. Postoperative complications, surgical technique, and the time course of reconstructive procedures were analyzed. Thirteen percent of patients with a history of RT had NAR compared with 36% of similarly reconstructed patients without a history of RT. Reconstruction was accomplished using a variety of local flaps, with an overall complication rate of 25%. Nipple-areola reconstruction after chest-wall irradiation in patients reconstructed with breast implants should be performed in carefully selected patients. Acceptable surgical candidates demonstrate resolution of acute radiation changes, no evidence of late radiation changes, and appropriate thickness of the mastectomy skin flaps.

Original languageEnglish (US)
Pages (from-to)12-15
Number of pages4
JournalAnnals of plastic surgery
Volume55
Issue number1
DOIs
StatePublished - Jul 1 2005
Externally publishedYes

Fingerprint

Nipples
Thoracic Wall
Breast Neoplasms
Radiotherapy
Breast Implants
Mammaplasty
Tissue Expansion Devices
Radiation
Mastectomy
Skin

Keywords

  • Breast cancer
  • Breast reconstruction
  • Nipple-areola
  • Radiation

ASJC Scopus subject areas

  • Surgery

Cite this

Nipple-areola reconstruction following chest-wall irradiation for breast cancer : Is it safe? / Draper, Lawrence B.; Bui, Duc T.; Chiu, Ernest S.; Mehrara, Babak J.; Pusic, Andrea L.; Cordeiro, Peter G.; Disa, Joseph J.; Hazen, Alexes; Lee, W. P.Andrew.

In: Annals of plastic surgery, Vol. 55, No. 1, 01.07.2005, p. 12-15.

Research output: Contribution to journalReview article

Draper, LB, Bui, DT, Chiu, ES, Mehrara, BJ, Pusic, AL, Cordeiro, PG, Disa, JJ, Hazen, A & Lee, WPA 2005, 'Nipple-areola reconstruction following chest-wall irradiation for breast cancer: Is it safe?', Annals of plastic surgery, vol. 55, no. 1, pp. 12-15. https://doi.org/10.1097/01.sap.0000168037.87942.b5
Draper, Lawrence B. ; Bui, Duc T. ; Chiu, Ernest S. ; Mehrara, Babak J. ; Pusic, Andrea L. ; Cordeiro, Peter G. ; Disa, Joseph J. ; Hazen, Alexes ; Lee, W. P.Andrew. / Nipple-areola reconstruction following chest-wall irradiation for breast cancer : Is it safe?. In: Annals of plastic surgery. 2005 ; Vol. 55, No. 1. pp. 12-15.
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AB - Radiation therapy (RT) is considered by some to be a contraindication to nipple-areola reconstruction (NAR) particularly in patients with breast implant reconstruction. In this retrospective chart review, all patients who underwent breast reconstruction with tissue expanders and implants from 1997-2003 were reviewed. A subset of patients with a history of radiation therapy (pre- or postoperative) was identified. Postoperative complications, surgical technique, and the time course of reconstructive procedures were analyzed. Thirteen percent of patients with a history of RT had NAR compared with 36% of similarly reconstructed patients without a history of RT. Reconstruction was accomplished using a variety of local flaps, with an overall complication rate of 25%. Nipple-areola reconstruction after chest-wall irradiation in patients reconstructed with breast implants should be performed in carefully selected patients. Acceptable surgical candidates demonstrate resolution of acute radiation changes, no evidence of late radiation changes, and appropriate thickness of the mastectomy skin flaps.

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