Doctor advice on completing radiation before or after DIEP surgery.

Q:  Hello. I am planning on having a double mastectomy with immediate diep flap reconstruction. The issue is that I have stage 1 invasive ductal carcinoma with a 12mm lump in my left breast. I won’t know if I will need radiation until after surgery. I was told by my plastic surgeon that there are risks with radiation post reconstruction, but she said I should go ahead with the diep flap as scheduled. As I’m researching this, all I’m seeing is I should wait until I have confirmed that I need radiation. Is this something I should reconsider? Thank you for your time.

A:  Excellent question! Unfortunately, there is approximately a 30% chance that if your DIEP flap receives radiation, it could irreversibly damage it so that it might not match the other side or become hard and firm. Therefore, unless we know for sure someone does not need radiation we wait until after radiation to do a DIEP.  Let me know if I can answer any other questions for you.

  • James E. Craigie MD.