Breast Reconstruction Particularities after Radiotherapy - Case Report.

Background: Patients undergoing postmastectomy breast reconstruction, with a history of prior radiation therapy, present a particular clinical scenario. This is because of their well-documented higher complication rates, secondary to deleterious effects of irradiation on the soft tissue envelope of the remaining breast. Case presentation: This article presents the case of a breast reconstruction in a 53-year old woman with two subsequent breast reconstruction procedures after being treated with chemotherapy and radiotherapy. The first procedure was placing an expander under the mastectomy skin flaps, but it was followed by complications requiring the removal of the expander. One year later the second procedure was performed with latissimus dorsi flap and implant with satisfactory results. But after two years from the latest procedure, the patient turned to our clinic for improvement of the cosmetic outcome. Taking into account the medical and surgical history of the patient and after a complete clinical evaluation, the decision was to perform the right breast reconstruction with contralateral unipedicle musculocutaneous TRAM flap. Conclusions: The aesthetic results of standard delayed breast reconstruction after radiation therapy in patients with locally advanced breast cancer are satisfactory at best, even in the hands of experienced surgeons. The result quality that can be obtained in a patient with previous radiotherapy is therefore less optimal than the one achieved in a nonirradiated patient. [ABSTRACT FROM AUTHOR]