October is breast cancer awareness month, which has become a great tradition as breast cancer affects more people we usually realize. Breast cancer affects one in eight women in America however because of improved surveillance and treatment there are currently over 2.5 million breast cancer survivors in the United States.
As part of the Breast Cancer Awareness Month, BRA (Breast Reconstruction Awareness) Day was created. This was done as part of the overall treatment of patients in their journey to beating breast cancer and resuming their normal life activities.
In the United States over 70% of women are not aware of their breast reconstruction options. Which include immediate or delayed (some time after the mastectomy) reconstruction, symmetrical procedure of the opposite breast and revisions to improve the appearance of the reconstructed breast. Currently less that 25% of women who have their breast removed for breast cancer undergo reconstruction. It is a personal decision if a woman wishes to undergo breast reconstruction but she should know that she has choice.
A study examining the barriers to reconstruction cited knowledge of these opportunities as the number one reason women did not undergo breast reconstruction. This is not the only reason as women decide not to undergo breast reconstruction at the time of treatment for a variety of reasons. However it is never too late to undergo reconstruction of your breast if you decide to do so at a later date. My own aunt had breast cancer and underwent a mastectomy, she did not undergo reconstruction as the thought of breast cancer alone was too much for her to think about reconstruction at that time. Last year, now ten years later she decided to have her breast reconstructed and has been extremely happy that she decided to do it after all these years.
In 2011 over 96,000 breast reconstruction procedures were performed in the United States. This was made possible in large part to the Women’s Health and Cancer act that was passed in 1998 that requires insurance companies to cover breast reconstruction.
What is Breast Reconstruction, what does this include?
Breast Reconstruction is performed when part of the breast or the entire breast is removed for cancer or another cause that leads to a deformity of the breast. The specific type of reconstruction is dependent on whether only a portion of the breast is removed or the entire breast. Breast reconstruction doesn’t stop there though, it also include a symmetrical procedure for the opposite breast whether it is a reduction, lift or augmentation. It also includes creation of a nipple and tattooing to create an areola.
Who can have Breast Reconstruction Surgery?
Every patient should have the discussion of breast reconstruction with their breast surgeon, oncologist or plastic surgeon if they are going have a mastectomy or lumpectomy. There are a lot of variables that determine whether a patient should have reconstruction at the time of their mastectomy or at a later date. There are also multiple reconstructive options that can be tailored to each individual patient as no one reconstructive method is perfect for every person. It is ok to make the decision to not have breast reconstruction, but we want patients to be educated about the options available to them during the process.
What is the Breast Reconstruction Process? Is there Different Methods to Reconstruct my Breasts?
Women have several options for breast reconstruction dependent on their individual desires and situation. The most common method of reconstruction in U.S. involves reconstruction with an implant (similar to what is used in breast augmentation). However the skin needs to be stretched to accommodate the implant so an expander (implant that can be filled gradually with saline) is placed and over a period time the skin is reshaped and then the final implant can be placed.
The second option for patients is to use tissue from another part of the body to recreate the breast. The abdomen is most common area used for this as most of us have a little extra stuff there that we wouldn’t mind giving up. Taking the abdominal tissue for breast reconstruction from this area is similar to how the skin and fat is removed for a tummy tuck.
The third and newest method of reconstruction is the use of fat grafting where fat is take from other parts of the body (liposuction) and used to reshape the breast. This can be done alone or in combination with either of the two above reconstruction methods. It can also be used to improve a previous reconstruction or treat an area of lumpectomy and radiation. It recreates the breast tissue that was removed and can improve the skin damage that was created by the radiation treatment. Fat grafting can also be placed over a previous implant based reconstruction to create a softer more natural breast. This recreates the fatty tissue that was removed during the mastectomy.
Recovery from Breast Reconstruction
Recovery from breast reconstruction depends on a number of factors including what type of reconstruction the patient undergoes. Reconstruction done with a tissue expander and implant often spend one night in the hospital and go home the next morning. While patients that undergo reconstruction with tissue removed from the abdomen or else where in the body often need a couple more days to recover from the procedure before they go home.
The most important thing to know from this article is that you have options and you should discuss these with your breast surgeon, oncologist or plastic surgeon. Have the discussion before your breast surgery so that you can make an informed decision of whether you want breast reconstruction or not. Also if you decided not to have breast reconstruction years ago, remember it is never too late and you can still see your plastic surgeon to discuss your options for reconstruction.