Radiotherapy on implant??

Hi there i have had a mx at the end of jan, with immediate reconstruction, using an expander implant, followed 2 weeks later with full node clearance. Only the sentinel node was infected.Then i have had fec-t chemo. I fall in the intermediate group regarding radiotherapy, meaning i didnt automatically get radiotherapy. I have been offered to take part in the supremo trial for radiotherapy, which is where you are picked at random. I have been selected, to have 15 treatments, starting on the 1st sept. I wanted to have all treatments available to blast the cancer, because i lost my mum to breast cancer 12yrs ago aged just 48. I am 41, and cannot bare the thought of my children going through what i went through when she died.
I had an appointment with my surgeon yesterday, and i am totally confused what to do now. He said that the radiotherapy will without a doubt destroy my implanted breast, he told me all the things that could go wrong, it will go hard and out of shape, the scar will pucker up. the skin will burn, and he said the implant could explode, and it could ulcerate. He also said that he would not touch it surgically, for atleast 12 months after to replace the implant for a permenent one.
I thought that the radiotherapy would treat behind the implant, thats where i thought a reoccurance would come, but he said thats very unlikely, it would more likely be on the skin, so therefore i would feel it. He said that if he honestly thought that i needed radiotherapy, he would rather have me here with a bad result to my reconstruction, that not have me here at all.
I totally trust this guy, he has been brilliant right from the start. He explains everything so well, and doesnt rush you out of the appointment. If the onc dr had explained this to me, i wouldnt of entertained the thought of radiotherapy at all, but she said it will be fine, and that they do loads of ladies with implants.
I might not of been chosen for the trial, so i wouldnt of known any different.
So why is it so hard for me to make up my mind what to do. I dont what to end up loooking a total mess,but i dont want to have cancer again in the future, and think to myself, if only i had gone ahead with the radiotherapy.

What would everyone else do in my position? or are there any ladies who have gone ahead with an implant to have radiotherapy?


Hi Sharon

It just shows you the differing opinions and comments, I too had immed recon with expander implant,last october, I had chemo then had 20 sessions of radiotherapy, I was told that the implant could harden, but they would just have to wait and see how it was a couple of months after, unfortunately mine hasn’t sofened or dropped but in all fairness it never did prior to radiotherapy, so I will be having a silicone one fitted shortly, it will be approx a year from the original surgery when this is done, i was never told it could explode or ulcerate, I would be scared to bits if my surgeon had told me all that.

I personally would go ahead with the radiotherapy it is important to have that, and fingers crossed your implant will be okay, all the best to you

ann x

Hi Sharon

Agree with Ann i think i would go ahead with the rads but it is your call. Do you think in the future you would regret it if you didn’t? I suppose if you even remotely think that you would it’s worth considering.

My onc and surgeon didn’t want to do an immediate recon, he said that it could damage it not that it would. Sorry i don’t know about the implant you have but if it’s an expander could they not deflate it first?


I had rads in sept/oct 2009.I had previously had a mastectomy in 2008 and immediate recon with LD flap and implant.
I was very concerned re possible damage to my recon and at first did not want rads,but I decided I had to do it.
I was only told that it might go hard and that the skin might tighten,but my onc was very reassuring and split my rads over 5 weeks instead of 3 to reduce the potential for damage.
10 months done the line I have noticed NO difference at all!
I did burn during rads but that healed up with no problems.
Good luck

Hi Sharon
I had 25 sessions of rads with an expander, then had it replaced for a cohesive gel implant a few months after Rads. I had no problems other than tightness with that implant. When I tried to have a nipple done later it wasn’t plain sailing, and I had problems because the skin was thin, but they were able to deal with that-I have a smaller implant in now which is fine and I think a slightly smaller implant when they first replaced the expander may have avoided the complications.
I think if it was me I would go for the radiotherapy, like others have said I wanted everything they could throw at it, but having to make a choice is really hard.
All the best with your decision.
C x

Hi Sharon I think I am in the same predicament as you. I have dseen one oncologist re radio & he has told me I am a borderline case. The available info means they cant at present prove there is a benefir in having radio in borderline cases such as mine. When benefir can’t be proven then they don’t recommend treatment. So he has not recommended treatment. Nevertheless I can have treatment if I want as he will put me in a national trial where they are putting half of borderlineladies in for radio & half not & tracking them over a number of years. I just feel I want radio just in case there is a benefit as I would never live with myself if I had a reoccurance & had not had all the treatment I could have. He is reffering me for a 2nd opinion on tuesday. I have had mx with imeediate reconstruction using the ld flap muscle from my back. The overall result is v good & the oncologist said it was one of the best he had seen in 20 yeras but I know the radio will adversely affect the reconstruction I am not really bothered about this. All that bothers me is the risk of lymphadema or long term pain as a result of radio in the breast or underarm. The onc said his opinion as to not having radio would have been the same even if I had not had reconstuction. Has any one been in similar situation & can give me any help in making my decision which I will need to do next week. Thanks

I had a skin-sparing mastectomy 3 weeks ago with sentinel node sampling and a temporary implant done at the same time. This was for widespread DCIS.

Got my results last week - no nodes affected and no invasive cells found. However DCIS was grade 3 and they didn’t get clear margins at the back. Unfortunately my surgeon was on holiday and the locum told me he was referring my case to the multi-disciplinary team meeting to decide whether to do more surgery, a course of radiotherapy or nothing. I go back on Wednesday to see my surgeon and find out their decision.

Meanwhile I am worrying myself to bits about it all. Obviously I’m pleased that the cancer hasn’t spread, but not so pleased that there may still be some lurking. My choice would undoubtedly be to have radiotherapy to be on the safe side except for the fact that I’ve already had an implant put in.

Does anyone know what can be done if rads cause the implant to go hard (encapsulation?) - can the implant and any hard tissue be removed and would I still be able to have a permanent implant? I know these are really questions for the experts but I would appreciate knowing if anyone has had radiotherapy successfully with an implant in place. It might mean I’ll get some sleep between now and Wednesday!

Thanks for any help.

Janet x