Breast Reconstruction – Latest Techniques in Breast Cancer Reconstruction After Mastectomy
In Jacksonville, breast reconstruction can be confusing and daunting process. When women are faced with the diagnosis of breast cancer, they are taken through a whirlwind of seeing doctors and receiving tests aimed at defeating the cancer. They receive a whole pile of information from their radiation oncologist, their medical oncologist, their breast radiologist, and their breast surgeon. All the focus is on eliminating the cancer. Our detection and treatment of cancer has improved over the years and women are living through the diagnosis of breast cancer, but what about after the cancer is gone. What are the options for women who have undergone a mastectomy or women who had a lumpectomy, but now have breast deformity? Many of these women had options for reconstruction performed at the same time as the mastectomy, but the focus was on killing the cancer. So next time you or someone you know has been diagnosed with breast cancer, please take a moment to reflect about the post-cancer needs of the patient. Ask these questions.
1. Is she a candidate for immediate breast reconstruction? (Reconstruction performed at the time of the mastectomy)
Patients with early stages of breast cancer who are not likely to receive radiation therapy are candidates for immediate reconstruction?
2. What are the advantages of immediate breast reconstruction?
Patients have less scarring and better cosmetic outcomes when the reconstruction is performed at the time of mastectomy. In addition, there is a proven psychologic benefit for patients undergoing immediate breast reconstruction?
3. Does immediate reconstruction delay other necessary treatments like chemotherapy?
Although some patients may have wound still to heal, most published studies demonstrate no difference in the time after surgery that chemotherapy is started whether or not patients undergo immediate reconstruction.
4. Does immediate breast reconstruction increase the chance of breast cancer recurrence?
Immediate reconstruction has no difference in local cancer recurrence from mastectomy alone?
5. Does immediate reconstruction decrease survival?
Patients undergoing mastectomy alone when compared to those receiving immediate breast reconstruction have no difference in the overall survival. Therefore, immediate breast reconstruction is oncologically safe and effective.
6. If she needs radiation therapy and is not a candidate for immediate breast reconstruction, are there options that can hep minimize the scarring?
Traditionally, all of patients requiring radiation were not offered immediate reconstruction. However, this paradigm is shifting and by working with the radiation oncologist we can place temporary tissue expanders to help keep all the original skin of the breast. Then after your radiation therapy is complete, we can replace the expander with your own tissue with or without an implant to complete your reconstruction. This process is called delayed-immediate breast reconstruction and is a mix between immediate and delayed reconstruction so that we can maintain all your original skin and minimize scarring.
7. What are the latest options for breast reconstruction?
The options for breast reconstruction are usually categorized by implant or autologous (using your body’s own tissue) based reconstruction. Implant reconstruction involves the use of a tissue expander (an inflatable implant) to recruit more skin before finally replacing the temporary expander with a silicone or saline implant.
Autologous Reconstruction is most commonly performed from tissue from your abdomen. The deep inferior epigastric artery flap (DIEP Flap) is performed by taking skin and fat from your lower abdomen and preserving ALL the muscle to recreate soft natural breast that will last the test of time. Using microsurgical techniques, your plastic surgeon will recreate the breast gland and shape. In addition, patients benefit from the tummy tuck they receive when the skin and fat from the lower abdomen is removed. Other autologous options include the superficial epigastric artery flaps and flaps taken from the buttocks.