Reconstruction

When a woman discovers she has breast cancer there are so many emotions to overcome, information to research and decisions to make that it can become overwhelming. It is important that each woman gain as much knowledge about the treatments, surgical interventions and reconstruction options available.

The number of women on the Eastern Shore opting for breast reconstruction has risen steadily over the past few years. The reasons for this increase are varied but they are directly related to the collective efforts of the entire breast cancer team. The breast cancer political lobby succeeded in passing a federal law which mandates all insurance carriers cover both reconstruction of the affected breast, as well as, the other breast in an effort to achieve symmetry. Plastic surgeons have contributed by refining their techniques and dramatically improving the quality of the reconstruction. In addition the general surgeons have been instrumental in providing access and information regarding treatment options to all newly diagnosed breast cancer patients.

Any woman with a diagnosis of breast cancer that is medically cleared for surgery is a candidate for breast reconstruction. While most reconstruction involves recently diagnosed women who are undergoing a mastectomy, they are not the only ones. Women who have had a lumpectomy and radiation in the past are eligible today. If they are unhappy with the appearance of the breast related to their previous treatment there are options available to correct this.

Breast reconstruction involves two basic types of techniques. One approach involves replacing the breast with a saline implant. In order to make up for the loss of skin during the mastectomy a two step process is utilized called tissue expansion. First a special expander is placed under the skin and pectoralis muscles. Then slowly, over a period of weeks, this implant is filled with salt water (saline) until the desired size is obtained. The expanding devise is then replaced with a softer, permanent implant. These implants are identical to the ones used in breast enhancement surgery.

The second technique involves using skin from somewhere else on the body to replace tissue lost in the mastectomy. This approach is called a TRAM flap in which skin from the lower abdominal area or occasionally from the back is transferred to the chest. A procedure similar to a tummy tuck is performed and instead of discarding the additional tissue, it is rotated in the chest area to take the place of the breast.

When is the best time for breast reconstruction? There are two timing options available, immediate and delayed. Immediate involves reconstructing the breast or at least starting the process at the time of the mastectomy. Delayed reconstruction could be six months or six years after the mastectomy or lumpectomy depending on the personal choice of the patient.

There are as many different reasons for undergoing breast reconstruction as there are different women being diagnosed with breast cancer. It is a personal decision unique to that individual. The basic goal however is to restore both form and function.