Breast cancer patients who want to have breast reconstruction immediately after their mastectomy can rest a little easier about their decision. A new study finds that immediate reconstruction does not delay the start of chemotherapy any more than mastectomy alone.

Some doctors worry that postponing chemotherapy beyond the typical 4 to 6 weeks after mastectomy might harm a woman's chances of successful treatment. Because chemotherapy can slow wound healing and having immediate reconstruction is more likely to cause wound complications, there has been some concern that immediate reconstruction might force such a delay in order to allow wounds to heal properly.

The new study, by researchers at the University of California, Davis, suggests those fears may be overblown. "We felt it was an important question to settle," said senior author Richard Bold, MD, an associate professor of surgical oncology at the UC Davis Cancer Center. "We wanted to document the safety of immediate breast reconstruction."

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Bold and his colleagues examined the medical records of 128 women who had mastectomies at the cancer center; of those, 62 chose immediate breast reconstruction.

Women who had immediate reconstruction were more likely to have surgical complications such as infections, collection of blood under the skin, and scabbing. However, those problems were not severe enough to delay their chemotherapy. Just 4 women overall were forced to delay chemotherapy beyond 6 weeks because of complications: 2 who had immediate reconstruction and 2 who did not.

The findings were published in the Archives of Surgery (Vol. 139, No. 9: 988-991).

Previous studies have shown that women who have breast reconstruction after mastectomy have improved self-image and well-being. Having the reconstruction immediately after mastectomy may enhance those effects.

Cosmetic results also may be better after immediate reconstruction, Bold said, because the surgeon can use techniques during mastectomy to preserve more skin, which helps give the reconstructed breast a more natural appearance.

Cost may be another consideration. Immediate reconstruction is often cheaper because it requires just one operation with one anesthesia procedure and one hospital stay. Exact costs, however, will depend on each woman's specific medical situation, the type of reconstruction procedure she chooses, and her insurance coverage.

Of course, breast reconstruction -- whether immediate or delayed -- may not be the right choice for every woman who has a mastectomy. Women need to consult with their cancer surgeon and a plastic surgeon to decide if the procedure is feasible and which type of reconstruction to choose if they decide to move ahead with the procedure.