Safe to radiate the chest wall through a silicone implant?

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luckylegs64
luckylegs64 Member Posts: 47
edited January 2015 in Radiation Therapy - Before, During, and After

Hello,

I underwent bilateral mastectomies with reconstruction using silicone implants in 2011 for DCIS of the left breast. I was diagnosed 3 years later ( September of 2014) with stage III c breast cancer. The cancer was found in 30/35 lymph nodes under my right arm, but otherwise scans were clean. Initially, my general surgeon said we need to radiate the chest wall on the right and therefore would need surgery to repeat the mastectomy and take down the silicone implant on the right. My plastic surgeon is questioning this as she says it is common to have radiation through silicone to treat the chest wall. I would love to think I don't have to have a repeat mastectomy! Does anyone have any experience or knowledge of this? Thanks in advance :-)

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  • Moderators
    Moderators Member Posts: 25,912
    edited December 2014

    Hi luckylegs, and welcome to Breastcancer.org. We're so sorry for what brings you here, but we're so glad you've joined us.

    Hopefully you'll get responses from other members soon but In the mean time, there is a whole section on Radiation Therapy in our main site where you can learn more about types of radiation, when is radiation appropriate, myths about radiation therapyetc, etc. We hope this helps!

    The Mods


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  • luckylegs64
    luckylegs64 Member Posts: 47
    edited December 2014

    thanks a bunch, I'll check it out

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  • YoungTurkNYC
    YoungTurkNYC Member Posts: 334
    edited December 2014

    luckylegs64 - I would think the chest wall is on the top and not under the silicone implant (as the silicone implants are supposed to go under your chest wall muscle).  But I am not a medical professional; it might be worth getting a second opinion about this.

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  • DiveCat
    DiveCat Member Posts: 968
    edited December 2014

    Implants would likely be under pectoral muscles, but they are still over a great portion of the chest wall. The chest wall is what protects your thoracic cavity and includes bone, muscle, fascia, etc.

    I'd be concerned about the ability of the radiation to penetrate the silicone at the needed strength to actually affect the chest wall, but you need to check with your oncologist and radiation oncologist. This is not the PSs area of expertise

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  • luckylegs64
    luckylegs64 Member Posts: 47
    edited December 2014

    Thank you for the feedback, I will keep asking questions of the doctors!

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  • muska
    muska Member Posts: 1,195
    edited December 2014

    Hi luckylegs, I completed radiation treatment about seven months ago and I had permanent silicone implant put in eight weeks before I started rads. This is not an ideal situation but it is a rather routine thing nowadays and as far as I know, some institutions even prefer to radiate with the implants vs having to put the implants in after rads.

    Radiation has no impact on the implant itself but usually shrinks and hardens the surrounding tissues which may result in some complications or cosmetic impact. However this does not mean that everybody suffers these side effects or that they are serious enough to require corrections.

    You mention that the comment was made by your general surgeon. I think you should discuss this with you radiation oncologist. Your plastic surgeon is already onboard. ROs take silicone implant into account when they put treatment plan together.

    One more thought: can it be your general surgeon suggests another surgery because he suspects a recurrence or residual cancer that may be overlooked because of the implant?


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  • luckylegs64
    luckylegs64 Member Posts: 47
    edited December 2014

    Thank you for the feedback! I'm encouraged to hear your experience. My mastectomy was nipple sparing, so it's true that the general surgeon could be worried about the small amount of breast tissue remaining. I would gladly give those nipples up if they could leave the implants, if for no other reason than to keep the skin at length during radiation. I am okay with some shrinkage and not a perfect looking reconstruction. Incidentally, my PET, breast MRI are negative. The discouraging thing for me is that my RO examined me and exclaimed that she felt like I had lots of breast tissue left after my mastectomy. My Plastic surgeon is the best in town for breast cancer recon and I trust her. She assures me that my skin is tissue thin and she got as much as she could. I think a second opinion is definitely in order...

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  • texas94
    texas94 Member Posts: 204
    edited January 2015

    luckylegs- I have the same question/concerns, and except for the fact all my cancer is on the left side, our histories sound pretty similar, including the ILC (and I'm sure we're equally grateful to be Stage IIIc and not IV!).

    My RO told my surgeon to leave my implant in place instead of remove it during my ALND surgery. He absolutely feels he can work around it, but I'm with you and have my fears the rads won't reach 100% of the target areas.

    However, aside from rads getting where it needs to be, 2 other things are in our favor. My plastic surgeon feels being able to keep my implant through rads will result in a better appearance at the end of this road, and he and my RO have both mentioned older reconstructions tend to do better with rads than newer (both the implant and the pocket).

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