Photograph: © PepeLaguarda/istockphoto
Being diagnosed with breast cancer is a life-changing event, but having information and a plan can ease some of the initial anxiety. “Many women don’t realize that they have several reconstructive options after a breast cancer diagnosis,” explains Dr. David Yan, MD, of Fairfield Plastic Surgery and Chief of Plastic Surgery at St. Vincent’s Medical Center in Bridgeport.
Depending on the individual’s disease, he explains, some women require a lumpectomy (removal of the cancer-affected area and small area of surrounding tissue) while others need a mastectomy (removal of all breast tissue). He explains that women often opt for some kind of reconstruction procedure after breast cancer surgery, which helps with the physical and psychological recovery after the operation. Other positive news is that after a mastectomy, most insurance companies cover reconstructive breast procedures, such as augmentation or reduction, to make the breasts symmetrical.
Here are a few helpful facts about the reconstructive side of breast cancer:
Know your options
There are several different types of reconstruction to choose from. Two-thirds of reconstructions are implant-based. This may involve having an implant put in right after the mastectomy or having a tissue expander (a silicone-like balloon) put under the breast muscle at the time of surgery. After several weeks of follow up appointments, the tissue expanders are filled with saline, allowing for a gradual increase in size of the new breast. After several weeks, the expander comes out and is replaced by an implant. Other types of reconstructive surgeries use your own tissue from the stomach, rear end or thighs, to reconstruct the breast and fix any contour problems.
Breast surgery has made great strides in recent years
In the past, doctors had to take off the entire breast during a mastectomy including muscles from the chest wall. Now, however, they’re able to perform many surgeries leaving much of the breast skin in tact. In some cases, the nipple and areola can also be preserved during a mastectomy. Incisions can be made under the breast or off to the side, resulting in a less invasive, more natural look.
Bring a list of questions to your doctor’s appointment
When dealing with breast cancer, there should be a multidisciplinary medical team approach. You’ll need an oncologist (cancer doctor), breast surgeon (who performs the mastectomy or lumpectomy), a radiation oncologist (administers radiation) and a plastic surgeon (who does the breast reconstruction). It’s essential to know the team who’ll be treating you, as well as how often and in what way they’ll communicate with you and each other. You’ll want to bring a list of questions to your first doctor’s visit, including, “How many follow up appointments will be necessary?” and “How long will it take me to recover?” Make sure you are comfortable with your team of doctors, because you’ll be seeing them often.
Bring a friend or family member to your doctor’s appointment
Bring someone with you to your first consult for support and note-taking help. Often times after a diagnosis, people are overwhelmed and can’t process all the information being given to them, so you need someone there to write down all the important information in a coherent way.
Take heart in that most patients are happy with their reconstruction
“I don’t think we’ve seen any patients who regret having breast reconstruction,” says Dr. Yan. Most patients feel better psychologically and do better with immediate reconstruction after a surgery. Dr. Yan adds that reconstruction is a restorative process, and can help women maintain a sense of being whole.
Find a support group
Whether face-to-face or online, research some support groups while you’re in the middle of planning your surgery. Ask your doctor if he or she can recommend any local groups, as you’ll need encouragement and reinforcement during your treatment.
For those in the CT area, Dr. Yan recommends the SWIM Across the Sound Breast Cancer Support Group at St Vincent’s Cancer Center
The Susan Komen Foundation has helpful information on support groups
Find other information on support groups or great cancer resources.
For more help finding doctors in your area and general information on cosmetic and reconstructive procedures, visit The American Society of Plastic Surgeons