Purpose: To evaluate implant breast reconstruction in patients who have received radiation prior to or following surgery for breast cancer.

Methods: Retrospective review of patients undergoing implant breast reconstruction by a single surgeon after mastectomy for breast cancer from 1996 to 2003.

Results: 108 patients (127 breasts) underwent mastectomy and implant breast reconstruction. 31 patients (32 breasts) received either pre- or postmastectomy radiation therapy. Major complications and total complications (major and minor combined) were more frequent in breasts that received radiation than breasts that did not receive radiation (25% vs. 6% for major complications, p<0.005, and 41% vs. 17% for total complications, p<0.01, respectively). Breast symmetry and patient satisfaction were significantly less in patients who received radiation (p<0.001 and p<0.05, respectively). Diabetes mellitus and chemotherapy were independently associated with increased complications but neither association was statistically significant.

Conclusion: Breast reconstruction in patients who receive radiation therapy is associated with more frequent complications and decreased aesthetic results. However, the present results compare favorably to those in prior studies. Improved results in the present study may be attributable to the use of newer prostheses, staged breast reconstruction with initial tissue expansion, total muscular coverage of the implant, and modern radiation therapy protocols.