For anyone interested in having breast reconstruction, trying to decide the best time to have it can be yet one more overwhelming decision. Generally speaking, you can have reconstruction at the same time as the mastectomy (this is called immediate reconstruction), or any time later (known as delayed reconstruction). Several factors can influence the timing of breast reconstruction surgery. These can include personal choice, access to a plastic surgeon, and other breast cancer treatments like chemotherapy and radiation.
Numerous studies show a higher risk of breast reconstruction complications in patients who have radiation, but the impact of chemotherapy on reconstruction is not as clear.
Chemotherapy can be given before surgery (known as neoadjuvant) or after surgery (adjuvant). A recent study published in JAMA Surgery followed 1881 women undergoing breast reconstruction (both implant-based and with autologous flaps). The study evaluated complication rates and patient reported outcomes. Chemotherapy (either before or after surgery) did not increase the risk for complications in patients undergoing breast reconstruction, regardless of technique. Likewise, there was no link between chemotherapy and any adverse patient satisfaction scores or poor psychosocial well-being.
This information can help empower women needing to make informed decisions regarding breast reconstruction timing in the setting of chemotherapy.
Patients should engage in shared decision-making conversations with their healthcare team to determine the best time for their breast reconstruction based on their individual needs and clinical situation.
For patients looking for help navigating breast reconstruction timing questions with their surgeons, the Breast Advocate® app can help! After taking users individual situation and preferences into account, the treatment Wizard provides evidence-based recommendations to review and discuss with your healthcare team. Download the free app today HERE.