Choosing to have reconstruction after breast removal may help patients take positive control of their breast cancer diagnosis and begin the emotional healing process, say plastic surgeons at Baylor College of Medicine in Houston.
"Our research has shown there is a significant implication that the life of the breast cancer patient improves after breast reconstruction," said Dr Lior Heller, associate professor in the Center for Aesthetic Surgery at BCM. "Breast cancer patients come to us very distressed and terrified of the unknown. When we teach them about their options for reconstruction, they feel in control of the diagnosis and feel that they are a partner in the treatment."
A woman newly diagnosed with breast cancer may be overwhelmed with unfamiliar information and faced with tough choices about her course of treatment. Reconstruction is a difficult part of treatment, but it is very important that physicians help patients with the difficult decisions through education and an explanation of their options, Heller said.
The most common options are surgery with an implant or surgery using the patient’s own tissue, said Heller. They include:
During the breast removal procedure, a tissue expander is placed under the skin and muscle to grow new tissue and form a new breast. Two to three months later, once the tissue is stretched to fit the patient’s desired implant size, the expander is replaced with the permanent implant.
Using fat tissue and skin from the patient’s lower abdomen or back, a surgical flap is created into a new, natural-looking breast mold. This is also done during the initial breast removal procedure and usually does not require another surgery.
"We individualise treatment for each patient," said Heller, also a plastic surgeon in the Lester and Sue Smith Breast Center at BCM. "Depending on the diagnosis and treatment, whether both breasts are removed or partially removed, if radiation or chemotherapy is done, together with the patient, we make a decision that suits her needs."
There are common myths about reconstruction, Heller said, including the fear that reconstruction may interfere with treatment and cause their oncologist not to detect a recurrence of the cancer. "Patients should talk with their plastic surgeon and oncologist about any concerns," said Heller.
"The means of reconstruction have improved and women are more comfortable making this decision," said Heller. "It is important for plastic surgeons to educate patients on their reconstruction options and reassure them of their decision. More and more patients are well-informed."
"You can see a huge sigh of relief come over the patients after the surgery," Heller said. "The change in the mood is amazing.”
(Source: Baylor College of Medicine: October 2008)