Wb. Jackson et al., POSTOPERATIVE IRRADIATION FOLLOWING IMMEDIATE BREAST RECONSTRUCTION USING A TEMPORARY TISSUE EXPANDER, Journal of the National Medical Association, 86(7), 1994, pp. 538-542
Ten consecutive patients at Howard University Hospital underwent modif
ied radical mastectomy with immediate breast reconstruction using a te
mporary tissue expander. Postoperative irradiation was delivered to th
e breast mound encompassing the tissue expander. The effects of expans
ion on the delivery of postoperative irradiation was assessed. Dosimet
ric measurements with thermoluminescent dosimeters revealed that the s
aline-filled expander attenuated the photon beam 3% less than tissue-e
quivalent material of equal volume. This dose variation was negligible
, so no adjustments were made. Postoperative treatment consisted of 50
40 cGy to 5220 cGy delivered in 5 to 10 weeks using 4 mV photon tangen
tials. Cosmesis was assessed over a 2-year period. Six patients comple
ted 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 go
od. 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 surg
eon and radiation oncologist.