For women with breast cancer, a mastectomy could be a lot to manage for recovery.
Furthermore, they have to make a decision about breast reconstruction, a procedure that may change their appearance and quality of life after cancer treatment.
The procedure can have physical and mental implications for patients whose cancerous breasts are surgically removed.
Breast reconstruction has some advantages. For example, doctors can restore the form. But it also brings some side effects.
It is important to know that breast reconstruction isn’t for everyone and needs not to be done immediately after a mastectomy.
Women and their doctors should have a wide-ranging discussion about options, timing, and risks.
Here are 5 things a woman needs to know before the surgery:
Start the conversation early
Although women ought to focus first on their cancer care, it can help to begin the reconstruction talk in advance with a doctor (and, ultimately, a board-certified plastic surgeon).
And women should not be afraid to come to an appointment with questions and seek a second opinion.
If deemed healthy enough and with early-stage cancer, a woman might opt for reconstruction surgery at the same time as her mastectomy to avoid multiple rounds of anesthesia and recuperation.
This can also help lessen the shock of losing an important part of her body.
Explore all possible options
One type of breast reconstruction involves saline or silicone-gel implants, and the other uses a patient’s body tissue from areas such as the thighs, back, buttocks or lower abdomen (i.e. a flat procedure).
About 75 to 80% of surgeries use the synthetic route, in part because of the simplicity of the procedure that all plastic surgeons are trained to perform.
Using patients’ body tissues requires plastic surgeons with additional skills.
But the lack of a specialized plastic surgeon locally shouldn’t discourage a woman from pursuing this procedure if that’s her best and preferred option.
Other patients might favor noninvasive action: external breast prostheses or nothing at all (recently described as “going flat”).
Surgery can be delayed
For emotional or physical reasons, some women seeking reconstruction may choose to wait.
And cancer-related circumstances could postpone others, including advanced disease that might require extended monitoring to ensure cancer doesn’t return.
Active smoking or pre-existing comorbidities can also push back the time of reconstruction.
Those who must undergo radiation treatments post-mastectomy are often encouraged to hold off, too.
Both options have risks
A flap procedure can labor-intensive and resource-intensive. It requires a larger surgical team, and patients can expect a lengthier operation and inpatient recovery because of the increased technical complexity of the tissue transfer.
However, patients with tissue reconstruction tend to be more satisfied over time.
Synthetic implants, meanwhile, could one day rupture or leak and require corrective surgery.
Over time, scar tissue around the implant (also known as a capsule) can thicken and harden, ultimately changing the shape and feel of the breast; this also requires corrective surgery.
Age is not a factor
According to recent research, older women who had a breast removed and reconstructed saw no greater frequency of post-surgical complications than their younger counterparts.
This means doctors shouldn’t discourage a woman from pursuing surgery because of her age.
That’s good news for many women, given that 40% of the 250,000 who will be diagnosed with breast cancer this year are 62 and older, according to National Cancer Institute data.
Older flap procedure patients, the study noted, had better physical, psychosocial and sexual well-being after reconstruction compared with younger patients.
The advice is provided by Adeyiza Momoh, M.D., a clinical assistant professor of surgery at the University of Michigan Medical School.
Source: Michigan Medicine.