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. When treatment involves 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.
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 die from the disease in 2016. Breast cancer death rates are higher for women in the U.S. than any other type of cancer, except for lung cancer. 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:
- Age – more likely to occur in women over the age of 55
- Radiation exposure to the chest prior to age 30
- No pregnancies or pregnancy after the age of 30
- Starting menstrual cycles before the age of 12
- Sedentary lifestyle, weight gain
- Hormone replacement therapy
- Smoking or consistent alcohol consumption
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.
Mastectomy, a surgical procedure to remove a breast, is one treatment option for women diagnosed with breast cancer. In 2015, 53 percent of women who were diagnosed with breast cancer underwent a mastectomy. About 25 percent opted for a single mastectomy, while 28 percent chose a double or bilateral mastectomy. In some cases, women opted to remove the healthy breast as well as the breast with cancer in order to reduce their risk of developing breast cancer in the opposite breast or to ensure breast symmetry. This is known as prophylactic mastectomy.
When mastectomy is the recommended treatment, there are many options to consider:
A surgical procedure that removes the entire breast, including the skin, nipple and areola.
This procedure involves removal of the entire breast, as well as the axillary lymph nodes. The decision depends on whether the cancer has spread to the lymph nodes.
This procedure, which is rarely performed these days, includes removal of the entire breast, the axillary lymph nodes and the chest (pectoralis) muscle.
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.
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. 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.
Women who decide to undergo reconstruction after a mastectomy may see numerous benefits from this decision:
- Restoration of a natural bodily form
- The ability to wear certain types of clothing and bathing suits comfortably
- May increase a woman’s self-confidence and self-esteem
- Can help a woman emotionally manage the difficult process of fighting breast cancer
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.
If you do decide to move forward with breast reconstruction, you will face many more choices throughout the reconstruction process. Some of those decisions will include:
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.
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.
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. 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.