Chemotherapy and wound healing.

Only patients with carcinoma of the breast who have a good prognosis after curative surgery are the best candidates for reconstructive surgery. On the other hand, patients who have a poor prognosis should not be considered for reconstructive breast surgery. Patients with guarded and intermediate prognoses who are candidates for adjuvant chemotherapy programs may be considered for reconstruction after completion of their programs and not prior to or during the programs. They should be evaluated at the end of such program, which ranges from one to two years, to assure absence of occult metastases and to assure complete bone marrow recovery. Even then, if metastases develop at a later date (after insertion of the prosthesis), tissue sloughing may occur at the site of the implant that may delay therapy or cause overwhelming infection.