New Surgery Options Help Breast Cancer Survivors

Recently, a friend told me about his mother’s experience with breast cancer. She was treated several years ago and underwent a mastectomy (removal of the entire breast). She considered having reconstruction to rebuild the breast, but decided not to when she learned that it would remove one of the muscles from her abdomen. Removing the muscle to rebuild her breast would lead to some weakness and a risk of hernia.

The good news for a woman facing breast cancer today is that many new reconstruction methods are available. The results from rebuilding the breast are usually very good or excellent, and often muscle does not need to be removed. For women with breast cancer who do not need a mastectomy, reconstruction is also an option to make the breast look better after lumpectomy (surgery to remove the cancer but leave healthy breast tissue in place). Here are a few of the newest approaches to breast surgery that have improved lives for women after breast cancer:

• Free flaps – A free flap is a breast reconstruction technique that uses a woman’s own body tissue (not an implant), and often does not remove any muscle. One common approach is to perform a “tummy tuck,” taking extra skin and fat from a woman’s belly, and then transplanting that belly tissue up to the chest to recreate her breast.
• Nipple-sparing mastectomy – A nipple-sparing mastectomy is an operation in which a woman’s breast tissue is removed, but none of the skin on top of the breast (including the nipple) is removed. Breast reconstruction is done at the same time. Keeping a woman’s own skin gives a natural-appearing result and means that an additional surgery to reconstruct the nipple is not needed.
• Lumpectomy with breast reduction – For a woman with a large tumor, mastectomy used to be the only option. Today, lumpectomy is sometimes possible if a breast reduction operation is done at the same time. A breast reduction operation is also performed on the other breast so the two sides match. Sometimes a woman with breast cancer chooses this operation even if her tumor is small, if she was already interested in having a breast reduction.

Survival after breast cancer has improved dramatically in recent decades. Because of this, specialists have placed greater emphasis on making sure women with breast cancer have the opportunity not only to survive, but to thrive after treatment. Newer reconstruction methods in breast surgery help women to thrive after breast cancer treatment by:

• Contributing to a positive self-image.
• Decreasing psychological stress from “re-living” the cancer experience when a woman looks at her scars.
• Promoting a healthy sex life.
• Preventing hernias and muscle weakness that can be caused by some types of reconstruction.

Remember, a woman who survives breast cancer today should not have to deal with self-consciousness about her body. If someone close to you is diagnosed with breast cancer, you can help her by making sure she is treated at a breast center that offers all of the modern approaches to breast reconstruction.

Author

Rubie Sue Jackson, MD, is a breast surgeon at the Fortney Breast Center.