Tissue Expansion: Do We Wait for Chemotherapy?
Breast cancer treatments often vary according to the characteristics of the cancer and the characteristics of the patient. Treatment modalities include surgical interventions and/or radiation therapy and/or chemotherapy (Carlson & King, 2012); in addition to the actual treatment of their cancer, patients can choose to pursue breast reconstruction as well. Given that cytotoxic chemotherapy can injure healthy bone marrow cells when attacking cancer cells, the resulting increased susceptibility to infection secondary to an impaired ability to produce neutrophils must be carefully considered when discussing breast reconstruction (Carlson & King, 2012). According to the American Society of Plastic Surgeons (ASPS, 2014), when considering breast reconstruction at the time of mastectomy, patients must weigh the benefits of a possibly expedited reconstruction process against any potential surgical risks posed by the initiation of chemotherapy. The purpose of this article is to provide an evidence-based discussion of the timing of tissue expansion for breast reconstruction as it relates to chemotherapeutic treatment of breast cancer.