Breast reconstruction: 4 things to know

For many breast cancer patients, breast reconstruction is an
important part of cancer treatment. The goal of breast reconstruction surgery is to recreate
part or all of the breast that has been removed during breast cancer treatment.

Reconstruction is known to benefit a patient’s body image and
quality of life. But recent research shows that, in the U.S., fewer
than 25% of breast cancer survivors understand the options for
reconstruction, as well as the risks and benefits.

Here are four things to keep in mind when considering breast
reconstruction surgery.   

Include your plastic surgeon early on

Talking with your plastic surgeon as early as possible in your
treatment will help ensure you have the best possible breast
reconstruction experience. It’s important to see someone who has
extensive experience in breast reconstruction for breast cancer
patients so that he or she fully understands the challenges of your
unique situation.

Here at MD Anderson, the patient’s care
team includes medical oncologists, radiation oncologists, breast
surgeons and plastic surgeons so that your care is coordinated. This
means we’re thinking about reconstructive surgery as we’re planning
and going through the different parts of your treatment.

Radiation therapy doesn’t limit your options

Radiation therapy may affect timing or the type of reconstruction
your plastic surgeon recommends, but reconstruction is almost always
an option.

In general, if we think that you need radiation therapy, we recommend staging your
breast reconstruction. This often involves a tissue expander placed at
the mastectomy and then using your own tissue in a second surgery. If
you have already had a mastectomy with radiation, your plastic surgeon
will need to rebuild a breast using your own tissue (from your lower
abdomen, buttock or back) with or without an implant.

Breast conservation surgery doesn’t mean you can’t have breast reconstruction

Breast conservation surgery (also called a lumpectomy) removes only
the tumor and keeps as much of the healthy breast tissue as possible.
It’s almost always followed by radiation therapy. This combination can
affect the size and shape of the breast and may lead it to be
mismatched with the unaffected breast. When this happens, a partial
breast reconstruction (also known as an oncoplastic reconstruction)
may be beneficial. We’re able to reshape your remaining breast tissue
to improve its appearance after radiation. The plastic surgeon may
also recommend a lift or reduction of the unaffected breast for
symmetry, either at the time of your lumpectomy or after radiation is complete.

The timing of your reconstructive surgery matters

When it comes to scheduling your breast reconstruction, you and your
care team may be able to choose whether to have the surgery before,
during or after the rest of your breast cancer treatment. But the
timing of your reconstruction can make a difference in the breast’s
appearance. Some factors that may change your breast’s appearance
include how much tissue is left after a mastectomy, scarring, or a
change in skin color as a result of radiation. That’s why it’s
important to meet with a plastic surgeon before having a mastectomy,
if possible.

Some breast cancer patients can undergo breast reconstruction at the
time of the mastectomy. For others, a staged approach is better, with
reconstruction starting at the time of the mastectomy and being
completed in a separate surgery after chemotherapy or radiation. But for some patients,
it’s best to delay breast reconstruction altogether, either because of
other medical factors or because the patient is not mentally ready.

The good news is that there’s no time limit on when you can get
breast reconstruction. Although immediate reconstruction after a
mastectomy may make surgery and your recovery a little tougher, it
won’t delay your treatment after surgery. Some women undergo
reconstructive surgery shortly after they’re done with treatment,
while others wait months or even years so they have time to recover
from treatment.

Whatever you prefer, remember to meet with your plastic surgeon
early in your breast cancer treatment so you know all of your options
and can pursue the reconstructive surgery timing and treatment that’s
best for you.