Breast Reconstruction After Mastectomy

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Can breast reconstruction hide cancer, or make it come back?

Studies show that reconstruction does not make breast cancer come back. If the cancer does come back, reconstructed breasts should not cause problems with chemotherapy or radiation treatment.

If you are thinking about breast reconstruction, either with an implant or flap, you need to know that reconstruction rarely, if ever, hides a return of breast cancer. You should not consider this a big risk when deciding to have breast reconstruction after mastectomy.

As of early 2011, the US Food and Drug Administration (FDA) shared concerns that breast implants may be linked to a few cases of a rare kind of cancer, known as ALK1-negative anaplastic large cell lymphoma (ALCL). This concern is mainly based on some case reports and a single observational study. Other studies so far have not shown any significant link. ALCL has been noted between 1 and 23 years after implants, and usually responds well to treatment. It can show up as a lump or as a collection of fluid near the implant. More careful studies are needed to find out what link, if any, there is between this rare cancer and breast implants.

Talk to your doctors about mammograms

It’s important to have regular mammograms on your other breast. If your reconstruction uses an implant, be sure to get your mammograms done at a facility with technologists trained in moving the implant to get the best possible images of the rest of the breast. Pictures can sometimes be impaired by implants, more so by silicone than saline-filled. Be sure your technologist knows about your implants before starting the mammogram.

Mammograms can be done with tissue flap breast reconstructions although they are generally not needed after a full mastectomy. Reconstructed breasts can look fatty, and surgical clips and scars may show up on the mammogram. Still, breast changes or abnormalities can be seen. Talk to your plastic surgeon and oncologist about this.

Breast self-examinations

After breast reconstruction, you may choose to keep doing breast self-examination (BSE). Check both the remaining breast and the reconstructed breast at the same time. This will help you learn what’s normal for you so that you can find any changes in the future. The reconstructed breast will feel different. The remaining breast may change, too, even if no surgery was done there. Your doctor or nurse can help you understand what’s normal so that you can notice and report any changes as quickly as possible. To learn how to examine your breasts, ask your doctor or nurse, call us, or go to our website to read, Breast Cancer: Early Detection.

Last Medical Review: 12/05/2014
Last Revised: 03/12/2015