What is the difference between performing reconstructive breast surgery following mastectomy and following lumpectomy?
Song: The thought processes are different. First and foremost, in lumpectomy reconstruction the best results are when lumpectomy reconstruction is performed immediate or early—immediate meaning at the same sitting as the cancer resection, early meaning that it is performed before radiation starts. This is typically a week or two after the lumpectomy, once the margins are clear. When lumpectomy reconstructions are done in these time settings, the results can be quite dramatic and aesthetically appropriate. When they are done after radiation, it’s an uphill battle and oftentimes it’s a losing battle. In lumpectomy reconstruction, because you are leaving a majority of the breast tissue intact and the patient has to get radiation for completion of oncologic treatment, you are radiating the majority of the breast tissue with the concept of having rearranged the breast tissue. In essence, you are radiating the entire breast that has been rearranged after lumpectomy. So, the entire breast is
