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Help on the WebBreast Reconstruction - Latest Techniques in Breast Cancer Reconstruction After Mastectomy

Breast Reconstruction - Latest Techniques in Breast Cancer Reconstruction After Mastectomy
By Ankit Desai

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.

In Jacksonville, breast reconstruction and the treatment of your breast cancer can be a difficult time for women. You should find a plastic and reconstructive surgeon as well as a general surgeon that you feel comfortable with, that can offer and explain all of your options to you. These options should include the use of expanders with or without a latissimus muscle flap as well as the DIEP flap. Microsurgical breast reconstruction is becoming more popular and you should find a plastic surgeon capable of performing both expander or implant based reconstruction as well as microsurgical breast reconstruction.

Contact us now at Desai Plastic Surgery to schedule your free consultation.

Ankit Desai, MD
Plastic Surgeon
Jacksonville, Ponte Vedra, & St. Augustine Cosmetic Surgery
Desai Center of Plastic & Reconstructive Surgery

 

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Background Information

 

The first sign of breast cancer is often a painless lump. But early breast cancer is often found on a mammogram before a lump can be felt.

Other symptoms of breast cancer may not appear until the cancer is more advanced. These include:

  • A thickening in the breast or armpit.
  • A change in the size or shape of the breast.
  • Changes in the skin of the breast, such as a dimple or skin that looks like an orange peel.
  • A change in the nipple, such as scaling of the skin or a nipple that turns in.
  • A green or bloody fluid that comes from the nipple.
  • A change in the color or feel of the skin around the nipple (areola).

About 1% of breast cancer occurs in men. Although most men diagnosed with breast cancer are older than 65, the disease can appear in younger men. For this reason, any breast lump in an adult male is considered abnormal.7

Inflammatory breast cancer is a specific type of breast cancer that involves the skin of the breast. It occurs when breast cancer cells form "nests" and block the lymphatic drainage from the skin of the breast. Symptoms include redness, tenderness, and warmth. Thickening of the skin of the breast (an orange-peel appearance), rapid breast enlargement, and ridging of the skin of the breast may also be present. Some women may also develop a lump in the breast. For more information, see the topic Inflammatory Breast Cancer.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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