Every year, nearly 300,000 American women are diagnosed with or living with breast cancer. The journey through diagnosis and treatment is often met with a new set of daunting decisions that include treatment options, from systemic therapies like chemotherapy to local therapies such as radiation or surgery.
If they choose surgery, women must consider a lumpectomy versus mastectomy, and whether or not to have breast reconstructive surgery.
"Women with the option will often choose to have just the tumor or a part of the breast removed in a procedure known as breast conservation surgery, lumpectomy, or segmental mastectomy, in conjunction with radiation to the remaining breast tissue," says Dr. Halls.
"Other women undergo a full mastectomy, in which all of the breast tissue is removed, and may avoid the need for radiation."
Available breast reconstruction options
Breast reconstruction, performed by a plastic surgeon, is the process of rebuilding the breast mound through surgical procedures after a mastectomy. In some cases, the breast skin and the nipple can be saved with mastectomy.
Immediate reconstructive surgery is performed or started at the same time as the mastectomy. This provides control over the location and extent of the scars, which can mean a better-looking result. Immediate reconstruction can also result in fewer surgeries in the future. Delayed breast reconstruction is sometimes recommended for women with advanced disease or other identified medical problems.
Dr. Halls recently developed a technique of immediate reconstruction that limits the scars to the fold underneath the breasts.
Moving forward with breast reconstruction
If you're thinking about breast reconstruction and whether it's right for you, discuss your questions and concerns with your doctor. At the time of your breast cancer diagnosis, you should have access to a plastic surgeon, and be sure that all possible reconstruction options are made available rather than just the surgeon's preferred technique.
Upon making the decision to move forward with breast reconstruction, Dr. Halls suggests the following:
- Select a board-certified plastic surgeon with experience in breast reconstruction
- Ask all questions prior to the procedure
- Take notes during meetings with the surgeon
- Record conversations with the surgeon to later review what was discussed
- Ask for clarification if anything seems uncertain or confusing
- Bring a partner or a friend along for support and to help you remember key points in the discussion
"Breast reconstructive surgery is an important decision that requires time, careful consideration and a great deal of solid information," says Dr. Halls.
"Women should decide what is best for them once they are fully informed and only when they are unquestionably comfortable with making the decision to move forward. While a physician can help in the process, choosing breast reconstruction is a very personal choice that must be respected."