Effects of Hyperbaric Oxygen Therapy in Breast Cancer Patients Undergoing Reconstructive Surgery to Irradiated Tissue

Breast cancer causes significant morbidity and mortality in women of all backgrounds.   It is estimated that 12.4 percent of women born in the United States will eventually develop breast cancer at some time in their life (National Cancer Institute). Treatment options include surgery, chemotherapy and radiation.  Radiation therapy is often utilized with mastectomy in the presence of advanced metastatic cancer (Fowble).  Radiation therapy is considered essential, thus managing complications becomes more important.   Delayed radiation complications include damaged microvasculature and ischemia, and may manifest six months to years later after the radiation exposure (Feldmeier).  Elective surgery is relatively contraindicated in areas of previous radiation, and may impact patients desiring breast reconstructive surgery (Marx).

Three breast cancer patients underwent chemotherapy, radiation, and mastectomy surgery.  Incisions healed completely.  Several months post-mastectomy, patients received breast reconstruction in irradiated areas with subsequent dehiscence.  Implants were removed leaving large wounds with significant tissue deficit.  Advanced wound care initiated (hydrofiber, foam, or negative pressure wound therapy) with minimal effect. The patients were unhappy with self-image and appearance.  But, additional surgery would net the same results.  An additional intervention was needed to change the outcome.

Patients received 30 hyperbaric oxygen treatments (HBOT) over a six-week period.   These patients underwent a second reconstructive surgery with primary closure, and ten additional HBOTs.  None experienced additional complications.  Patients overwhelmingly verbalized satisfaction with their appearance and outcome. 

Most patients who have undergone mastectomy with radiation and subsequent breast reconstruction heal without further interventions.  However, a small percentage of patients will experience late effects of radiation.  For this population, HBOT can significantly improve quality of life, enhance self-image, eliminate wound care expense, and decrease risk of infection.  Limitations are minimal, mostly based on the individual’s tolerance of HBOT.  

HBOT stimulates angioneogenesis and increases oxygen content in irradiated tissue, promoting wound healing ability (Hampson).