Reduction mammaplasty in the previously radiated breast: is it safe and does it interfere oncologically?

Lumpectomy with axillary dissection followed by irradiation for early breast cancer, also known as breast conservation therapy, offers less radical surgery with similar rates of survival and recurrences. However, following radiation therapy, temporary and permanent, early and late changes of the breast soft tissue can occur. Thus, any subsequent elective surgery can potentially end in disappointment and disaster. The safety of reduction mammaplasty following irradiation and its effect on oncological follow-up are not well known. In this case report, a 39-year-old female patient is presented. Her breast carcinoma was treated with breast conservation therapy plus irradiation, followed by breast reduction using the inferior pedicle technique 2.5 years later. Postoperative healing was uneventful with no postoperative complications and the aesthetic result was satisfactory. We strongly believe that surgery should be delayed until resolution of the early signs of radiotherapy. Regardless of the technique, if surgical steps are performed delicately on appropriately selected patients, reduction mammaplasty can be accomplished safely. Of course, pathological evaluation of the resected material, as well as postoperative mammograms are essential in order to detect any recurrence.