What is the Difference Between Immediate and Delayed Breast Reconstruction?

Patients with a newly diagnosed breast cancer may be candidates for breast reconstruction at the time of mastectomy. This is commonly referred to as "immediate breast reconstruction".

The limiting factor for immediate breast reconstruction is the need for irradiation therapy. Typically, the decision for irradiation therapy is made by your care providing team and is based on your tumor size (> 5cm) and evidence of local spread of cancer to the lymph nodes under your arm (typically 4, or more). There may be other characteristics of your tumor that may suggest a need for irradiation therapy even if its size is < 5cm or if you have fewer that 4 lymph nodes involved. Your personalized treatment team will be able to help you to determine the best treatment for you.

Dr. Marga is pleased to work with your care team to determine your candidacy for immediate breast reconstruction.

If you should need irradiation, we may be able to offer you a temporary tissue expander or saline-filled "spacer" or "babysitter breast implant" to preserve your appearance in clothing during chemotherapy and irradiation, a technique we call the "burn no bridges" approach. Typically, the final stages of breast reconstruction, implant vs. tissue flap, are initiated 6 months after the completion of irradiation therapy. This has been referred to in the scientific literature as "delayed primary breast reconstruction" as the most important stage of the breast reconstruction occurs at some time after mastectomy.

Patients who did not have any form of reconstruction in the setting of mastectomy and present for reconstruction at a later date are categorized as candidates for "delayed reconstruction". All stages of their reconstruction are performed at a date later than their mastectomy.

There are some technical differences between immediate and delayed reconstructions that may affect your eventual cosmetic appearance. Dr. Marga will be pleased to address these issues with you at the time of your individualized consultation.

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