Expert: Minas T Chrysopoulo, MD - 4/12/2008

Question
Hi Dr. Chrysopoulo,
1. Can a reconstructed breast mound, such as the DIEP flap,
obscure local cancer recurrence? (I had multiple small tumors very near chest wall)
2. If wounding enhances tumor progression, can reconstructive surgery shorten long term survival?
Thank you,
Mary

Answer
Mary,

DIEP flaps or any other method of breast reconstruction can potentially delay the diagnosis of recurrent local disease of the chest wall (chest muscles). However, many studies have shown that breast reconstruction does not impact local recurrence or long term survival in patients with early breast cancer (stage I and II). The rate of breast cancer recurrence and length of survival is the same in patients with stage I and II disease whether they undergo breast reconstruction or not. For this reason most institutions (including ours) offer breast cancer patients with early disease immediate breast reconstruction whenever possible.

Patients diagnosed with advanced disease are more likely to be candidates for delayed breast reconstruction once they have completed their cancer treatment and remained disease free for several months. Breast reconstruction surgery (with a DIEP flap or any other method) does not encourage or enhance tumor recurrence or shorten long term survival.

Hope that helps.

Dr Chrysopoulo
PRMA Plastic Surgery, San Antonio, Texas
http://www.prma-enhance.com/index.cfm/PageID/1754
http://www.prma-enhance.com
http://breast-cancer-reconstruction.blogspot.com