In a nutshell
This is a 2018 update on breast reconstruction following breast cancer treatment. It has been found that nearly 40% of women who undergo a mastectomy will have a breast reconstruction.
Some background
It was estimated that in 2017 106000 reconstructive breast surgeries were done. The main reason for this is to do with the psychological well-being of the patient. Patients who undergo a lumpectomy, where a small portion of the breast containing the cancer is removed, may undergo a reconstruction. This may be because taking out the cancerous cells results in a differing shape of the breast. In this case, techniques using the remaining breast tissue to remake the affected area are common. For patients who have undergone a full mastectomy, where the whole breast is removed, two options are available. The most commonly chosen option is using an implant. It is also possible to use the patients own tissue to remake a breast, although this is a much more difficult procedure.
Methods & findings
Implants are made of a silicone shell and get filled with saline or silicone gel until they are the right size. Some doctors thought that silicone might be dangerous as an implant, but it has been proved that it is not dangerous or related to any disease. When the patient has the mastectomy, the surgeon can place “tissue expanders” under the skin, which are then filled with saline in a series of injections after the surgery, then replaced with a silicone implant once the right size is reached. This type of procedure is quite short, has little scarring, and needs very little recovery time.
As mentioned, the other option is using tissue from the patient themselves and fashioning it to look like a breast. This is much longer and more complicated. It can be done by taking muscle from the buttocks, the upper back, or the stomach.
Most patients have the reconstruction done at the time they have the mastectomy because this means only one surgery needs to be done. However, in some cases, this is not possible. For example, when the patient has to undergo additional radiation after surgery. In this case, it is done after the radiation, which decreases the chance that the reconstruction will fail.
The bottom line
This study concluded that breast reconstruction after mastectomy is becoming more common. There may be some risks associated with implants (which have not been proven yet), but the decision to undergo reconstruction is entirely up to the patient.
What’s next?
If you are considering breast reconstruction, speak to your oncologist and cosmetic surgeon about the best course of action to take.
Published By :
Journal of the American Medical Association (JAMA)
Date :
Aug 31, 2018
