According to the most recent figures, this year in the United States over 230’000 women will be diagnosed with breast cancer. Of those women a shocking 40’000 will die from the disease.
Many women who do survive in their battle against breast cancer must have a mastectomy to do so (the removal of one or both breasts). For many women, their breasts are an important part of their sexuality and the loss of them is a difficult thing emotionally and physically. Unfortunately, some women feel less attractive after they have had their breasts removed. For many women a mastectomy can be especially traumatic because it is a constant reminder of their illness, whenever they look in the mirror. It can also hurt a woman’s confidence and lead to other social and employment issues if they don’t have good confidence in their health and appearance.
New breast cancer research suggests that to overcome negative feelings associated with the loss of an important body part, more women are opting to have breast reconstruction. Breast reconstruction attempts to maintain the shape of a woman’s breasts through one or more surgical procedures. A breast reconstruction can be undertaken at the same time as the mastectomy operation or at a later date.
Most insurance plans that pay for mastectomies will also pay for breast reconstruction, thanks to a federal government law enacted in the 1980s. The increase in the number of women opting for breast reconstruction may be in part due to this law, which saw their insurance plans update to provide the extra coverage.
The research, published in the Journal of Clinical Oncology, looked at more than 20’500 women who had mastectomies between 1998 (when the law passed) and 2007 and examined how many went for a breast reconstruction. 46% of women opted for reconstruction in 1998 and that number rose to 63% by 2007. Many more women are aware of the option to have breast reconstruction and breast cancer treatment options are much more widely known now.
Interestingly, the study found that there was a great disparity in the number of women opting for reconstruction, based upon their location. The lowest was North Dakota where only 18% of women opted for breast reconstruction and the highest was Washington DC, where 80% underwent the procedure. Researchers suggest that may be to do with the number of plastic surgeons in the area, with women in North Dakota unaware of the reconstruction options and outcomes due to a lack of plastic surgeons.
There are two forms of breast reconstruction, one using fake breast implants and the other using tissue from other parts of the body, “tissue flap reconstruction”.
There are advantages and disadvantages to both types of breast reconstruction surgery:
Use silicone or saline implants which are inserted under the muscle tissue in the breast and attached to the chest wall.
The main advantages of implants are:
- A very simple operation with a high success rate
- Short recovery time
- Scarring is only around the breasts
The main disadvantages of implants are:
- The breasts may not look as natural as the other form of reconstruction
- They may not look the same as your original breasts
- If you lose or gain weight, the breasts will stay the same size, which can lead to an odd appearance.
Using your own Tissue
“Tissue flap reconstruction” will use your own tissue, fat and skin from another section of your body. There are two types: attached flaps and free flaps. Attached flaps will use material from your back or abdomen, the material is “tunneled” up to the breast area. Free flaps will use material from buttocks or abdomen, but the material is detached and then reattached to the breast area with arteries and veins attached to the blood supply of the breast wall.
The main advantages of tissue flap reconstruction are:
- The breasts look more natural and can look similar to your original breasts.
- The breast will gain and lose size as your weight changes so it can look more natural.
The main disadvantages of tissue flap reconstruction are:
- The recovery time is longer than implant surgery
- You will have additional scarring on the area where the tissue was found.
- You may lose strength in your abdominal muscles if you sourced tissue from that area
- There is a small risk the flap tissue will die due to a lack of blood supply, and will need to be replaced
The research paper indicated that most women opted for implants instead of tissue flap reconstruction, but women are more aware of the all of the options now. Some women report that going through reconstruction surgery after having received a mastectomy years before actually felt like a very positive and healing process.
The main thing for women to be aware of is that there are options and with modern surgical practices, the end results look fantastic.