While the focus is on breast cancer awareness this month, it is a good time to give women the basic facts on breast cancer treatment and options afterward. Breast cancer surgery, including different types of breast surgery such as mastectomy and lumpectomy, is a key part of treatment for many women, and understanding your average risk can help guide decisions about screening and preventive options. When treatment involves the removal of a portion or all of a breast, reconstruction procedures can help women regain their feminine contour and reclaim their life after breast cancer. Dr. Andrews at Dr. Andrews Plastic Surgery has the great insight into the many choices women have in breast reconstruction today.
Introduction to Breast Cancer
Breast cancer is a disease that begins when abnormal cells in the breast tissue start to grow uncontrollably, forming a tumor that can invade nearby tissue and potentially spread to other parts of the body. While breast cancer primarily affects women, men can also develop this type of cancer, though it is much less common.
As one of the most frequently diagnosed cancers worldwide, breast cancer is a leading cause of cancer-related deaths among women. Raising breast cancer awareness is essential, as understanding the signs, symptoms, and risk factors can lead to early detection and better outcomes. Early detection through regular screenings and being aware of changes in the breast are key steps in improving survival rates and quality of life for those affected by breast cancer. By staying informed about breast health and the latest advances in cancer awareness, individuals can take proactive steps toward prevention and timely treatment.
Breast Cancer Statistics
Breast cancer is one of the most common cancers diagnosed in the United States. One in eight women develop invasive breast cancer during their lifetime (source: breastcancer.org). In addition, about one in 1,000 men will be diagnosed with breast cancer at some point during their lifetime. It is estimated that more than 300,000 new cases of breast cancer will be diagnosed in women in 2016 alone, and approximately 2,600 breast cancer cases in men.
While deaths associated with breast cancer have been decreasing since 1989, about 40,500 women are expected to pass away from the disease in 2016. The gradual decrease in death rates can be attributed to more early detection of the disease and more effective treatment options.
While genetics can play a role in breast cancer, as many as 85 percent of all breast cancer cases diagnosed are in women with no family history of the disease. Other risk factors for breast cancer include:
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Age – more likely to occur in women over the age of 55
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Radiation exposure to the chest prior to age 30
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No pregnancies or pregnancy after the age of 30
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Starting menstrual cycles before the age of 12
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Sedentary lifestyle, weight gain
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Hormone replacement therapy
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Smoking or consistent alcohol consumption
Most women fall into the average risk category for developing breast cancer. Understanding whether you are at average risk or higher risk can influence your screening and prevention strategies.
None of these risk factors mean a woman will definitely develop breast cancer, but they can make her likelihood of a cancer diagnosis higher than women who do not have any of these risk factors.
Preventing Breast Cancer
Taking steps to prevent breast cancer involves a combination of healthy lifestyle choices and, for some, medical interventions. Maintaining a healthy weight, staying physically active, limiting alcohol intake, and avoiding smoking are all important ways to lower the risk of developing breast cancer.
For individuals who are at high or very high risk, such as those with a strong family history or genetic mutations like BRCA1 or BRCA2, additional preventive measures may be recommended. These can include prophylactic mastectomy, which is the removal of one or both breasts before cancer develops, or chemoprevention, which uses medications to reduce the risk of breast cancer.
Regular screening, including mammograms and clinical breast exams, is crucial for early detection and can help catch cancer at an early, more treatable stage. The National Cancer Institute and other leading health organizations provide up-to-date guidelines to help individuals understand their risk and make informed decisions about breast cancer prevention and early detection.
Mastectomy Trends?
Recent years have seen significant changes in mastectomy trends as breast cancer treatment continues to advance. More women at high risk for breast cancer are choosing bilateral mastectomy, which involves removing both breasts, as a preventive measure. Procedures like nipple sparing mastectomy and skin sparing mastectomy have gained popularity due to their ability to preserve more of the breast skin and, in some cases, the nipple, making immediate breast reconstruction more natural-looking and appealing. Modified radical mastectomy, which removes the breast and some of the lymph nodes under the arm, remains a common choice for certain cases, while radical mastectomy is now rarely performed.
The decision about which type of mastectomy to undergo depends on factors such as the stage and type of breast cancer, personal preference, and the advice of the surgical team. Ongoing clinical trials and research are helping to refine these procedures, offering patients more options and better outcomes in both cancer control and cosmetic results.
Options in Mastectomies
When mastectomy is the recommended treatment, there are many options to consider. The different types of mastectomies vary in how much tissue is removed, depending on the specific procedure and patient needs.
Breast conserving surgery is another option for some women, and concerns about breast cancer coming back may influence the choice of surgery.
Simple Mastectomy
A total mastectomy, also known as a simple mastectomy, is a surgical procedure in which the surgeon removes all the breast tissue, including the skin, nipple, and areola. This type of mastectomy removes all the breast tissue to ensure that all the cancer is eliminated.
Modified Radical Mastectomy
This procedure involves removal of the entire breast and the underarm lymph nodes. During a modified radical mastectomy, the surgeon will remove lymph nodes from the underarm area to check for cancer spread. In some cases, it may be necessary to remove nearby lymph nodes if cancer is found, which helps determine the stage of the disease and guide further treatment. If cancer is detected in additional nearby lymph nodes, more extensive surgery may be required to ensure all affected tissue is removed.
Radical Mastectomy
This procedure, which is rarely performed these days, includes removal of the entire breast, the axillary lymph nodes, and the chest muscles, specifically the pectoral muscles. This extensive surgery is usually only performed if breast cancer spreads to the chest wall muscles.
Skin-Sparing Mastectomy
While the nipple and areola are removed with this procedure, as much of the breast skin as is possible is preserved. This technique is often recommended when breast reconstruction will be performed at the same time as the mastectomy.
Nipple-Sparing Mastectomy
In addition to sparing as much skin as possible, this procedure will also preserve the nipple and areola for the purpose of a more natural breast reconstruction. Nipple-sparing mastectomy is often an option for women with early stage cancer or early stage breast cancer that has not spread to the skin or nipple. In this case, the tissue under the nipple will need to be carefully removed and biopsied to ensure no cancer cells will be left in the remaining skin.
If you need a mastectomy and are considering breast reconstruction, it is a good idea to involve a plastic surgeon as early in the process as possible. While the ultimate goal is always to completely remove the cancer, the plastic surgeon can work with your cancer surgeon to ensure the best possible results from both your mastectomy and your reconstruction procedure. Proper care of the surgery site after your operation is important to reduce the risk of complications such as infection or bleeding.
Benefits of Reconstruction
Women who decide to undergo reconstruction after a mastectomy may see numerous benefits from this decision:
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Restoration of a natural bodily form
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The ability to wear certain types of clothing and bathing suits comfortably
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May increase a woman’s self-confidence and self-esteem
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Can help a woman emotionally manage the difficult process of fighting breast cancer
Some women may choose to use a breast prosthesis instead of undergoing reconstruction, as it can help restore a natural appearance without additional surgery.
Despite the many benefits, breast reconstruction is not right for every woman. It is important to talk to your oncologist as well as a plastic surgeon to determine whether breast reconstruction is the right choice for you.
Options in Reconstruction
If you do decide to move forward with breast reconstruction, you will face many more choices throughout the reconstruction process. Breast reconstruction surgery, also known as reconstructive surgery, is an important part of the overall treatment plan for many women after mastectomy. Some of those decisions will include:
Timing of the Reconstruction
Reconstruction can be done at the same time as the mastectomy (known as immediate reconstruction) or weeks to months after the mastectomy (known as delayed reconstruction). Your decision will be based on your personal preference, your age and medical history, the preference of your surgeons and whether additional cancer treatments like radiation or chemotherapy will be required after the mastectomy.
Technique Used for the Reconstruction
There are two basic techniques that are employed for breast reconstruction. One is the use of a breast implant to replace the breast tissue removed with the mastectomy. The second is to use your own tissue, taken from a donor site like the abdomen, the back, the buttock or the thigh. In some cases, a combination of implants and your own tissue may be used to produce the best result.
Resources and Support
Facing breast cancer can be overwhelming, but a strong network of resources and support can make a significant difference throughout the journey.
Emotional support from family, friends, and support groups helps patients cope with the challenges of diagnosis, breast cancer treatment, and recovery. Professional counselors and therapists can provide guidance for managing the psychological impact of cancer. Organizations like the American Cancer Society and the National Breast Cancer Foundation offer a wealth of information on breast cancer, treatment options, and how to find support services.
During Cancer Awareness Month, communities often come together to raise awareness and funds for breast cancer research and patient programs, providing additional opportunities for connection and encouragement. Reaching out to others who have experienced breast cancer can offer valuable insights, hope, and a sense of solidarity, reminding patients that they are not alone in their fight against cancer.
Schedule a Consultation
Breast cancer is a difficult diagnosis for women and the beginning of an often long process to manage the disease. One of the steps in that process may be breast reconstruction. In addition to reconstruction, other treatments such as hormone therapy, chemotherapy, targeted therapy, or radiation may be recommended as part of a comprehensive approach to breast cancer care. If you are considering breast reconstruction, please call Dr. Andrews Plastic Surgery at 855-338-0261 to schedule your personal consultation with Dr. Andrews today.
