Wellness Wednesday: Breast cancer reconstruction; what you need to know

SALT LAKE CITY, Utah - October is Breast Cancer Awareness month, and like many Utahns you likely know someone battling this disease.

Intermountain Healthcare knows that for breast cancer patients, the battle against the disease is not the only scary part. Recovery can also be daunting, and it is important to know what options patients have when it comes to reconstruction surgery.

Before undergoing a mastectomy, patients should see the expertise of a plastic surgeon to help determine what type of reconstruction they are able to have. This is will provide the patient peace of mind that they have been able to select their treatment from the best available options.

There are three main types of breast reconstruction surgery available including:

• Implant only
• Using your own body tissue only
• Implant, combined with using your own body tissue

Here are some important questions keep in mind during the consultation with your plastic surgeon:

Which method of reconstruction is best for me?
This is determined by your body shape, past surgery, current health, treatment needs, and personal preference. Talk to your surgeon to discuss options, risks, and benefits.

How long is the reconstruction process?
Timeline will vary depending on how many surgeries need to be done and the need for other cancer treatment. Typical reconstruction process takes 6 months to 1 year.

What if my natural breast does not match my reconstructed breast?
The goal is to create a breast that is symmetrical with the remaining natural breast. Augmentation of both breasts may be necessary to achieve desired result.

It has been ten years since I had my breasts removed, can I still have reconstruction surgery? Who pays?
In 1998, Congress passed the “Women’s Health and Cancer Rights Act” which requires group health and individual insurance coverage for reconstructive surgery following a mastectomy. Talk to your insurance or surgeon about your options.

What are the risks of breast reconstruction surgery? Does reconstruction change the risk of my cancer returning? Does it make cancer detection harder?The risk of breast cancer recurrence depends on the stage of the disease, biological characteristics of the cancer and the additional breast cancer treatments. Reconstructive surgery has not been shown to increase the risk of cancer returning or make it harder to detect cancer if it does return.

What if I may need radiation?
You may want to delay breast reconstruction until you are finished with radiation therapy. Radiation may damage your reconstruction and affect your final cosmetic result.

What if I may need chemotherapy?
Breast reconstruction should not delay chemotherapy treatments. Usually your medical oncologist will wait until you have healed from your mastectomy and reconstruction before starting chemotherapy. Your surgeon and oncologist can discuss your specific treatment plan.

What is DIEP breast reconstruction?
DIEP (deep inferior epigastric perforator) flap reconstruction restores the breast using a patient’s skin and fatty tissue from the lower abdomen below the belly button. The procedure results in a “tummy tuck” as well. The DIEP flap procedure is ideal for women with an active lifestyle as well as for those who have undergone double mastectomy who don’t want implant-based reconstruction.

DIEP flap breast reconstruction is popular because it doesn’t move or cut muscle (which means shorter recovery time).
Sensory nerve reconstruction can be performed with the DIEP flap to restore sensation after mastectomy. The reconstructed breast is permanent. A patient’s breast grows/shrinks with them. If the patient gains weight, their breasts change accordingly. Same thing if they lose weight/diet, their breasts change naturally with their body. Within 5-6 weeks most patients are getting back to their normal daily routines with few, if any, restrictions.

If you are a female over 40, take the time this month to schedule your annual mammogram. It is a quick procedure that can help save your life.

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