Introduction: Timing of autologous tissue breast reconstruction in patients who require radiation therapy is controversial. Some advocate postponing reconstruction until a final decision regarding radiation treatment is made. The purpose of this study is to assess outcomes in patients who underwent autologous tissue breast reconstruction and subsequent irradiation.

Methods: Consecutive patients who underwent autologous tissue breast reconstruction prior to radiation treatment were identified. Patient self-assessment of aesthetic and psychological outcomes was obtained by a two-part questionnaire. Independent evaluation of aesthetic outcomes by physical exam was obtained. The data was collected and compared using Kendall's tau correlation analysis.

Results: Twenty-seven patients met the inclusion criteria and of these 14 participated in the study. Patients were generally satisfied with their aesthetic outcome and physical exam assessment by two uninvolved physicians mirrored the patients' self-perception. However, patients did not derive significant psychological benefits despite superior aesthetic outcomes.

Conclusion: Radiation therapy after autologous breast reconstruction does not adversely affect aesthetic outcomes as measured by patient self-assessment or a physician's physical exam. Psychological measures of satisfaction in post-mastectomy reconstruction are more nuanced and don't necessarily correlate with purely aesthetic measures.