breast cancer

Breast Reconstruction Surgery as a Part of Breast Cancer Treatment

Dr. Jaydip Biswas
17 Nov 2018
 4.51 Vote(s)
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Breast reconstruction aims to remove cancer and sustain the shape and symmetry of breast. It provides autologoustissue to construct a natural looking breast along with the reformation of a natural lookingareolaandnipple. Learn more about the type, benefits and risk of breast reconstruction surgery in this article.

Breast reconstruction surgery is reconstruction of the breasts to near normal shape appearance, symmetry and size for those women who have had a mastectomy because of breasts cancer. Reconstruction is mainly done by restoring symmetry between the two breasts by replacing the breasts tissue, skin and the creating removed nipple. There are many procedure for breast reconstruction, it either can begin at the time of mastectomy or delayed until a later date. Breast reconstruction can be different for different women depending upon the mastectomy, size, width and location of the tumor removed. Many women choose to have reconstruction surgery because the long-term prospects of living without a breast can be painful. Although improvements in plastic surgery may mean better results now, many women still choose to skip reconstruction and continue to wear external breast forms or pads. The gorgeous appearance is acceptable to many women, but the reconstructed area remains completely numb after the surgery, which results in loss of sexual function and other abnormalities. 

Symptoms of Breast Cancer

Some of the symptoms of breast cancer include the following:

  • Lump or swelling in the breast
  • Change in texture of the skin around the breasts
  • Change in shape and size of the breasts
  • Rash or crusting around the nipples
  • Unusual discharge from nipples
  • Unusual change in nipples

Risk Associated With Breast Reconstruction Surgery

The decision to have a breast reconstruction is extremely complicated because there are potential complications in it and the surgery does not change the risk of breast cancer recurrence. Patients need to be fully aware about the risks and complications involved before and after the surgery. Breast reconstruction can often be carried out immediately following the mastectomy, lumpectomy or congenital deformities. The infection rate may be higher at primary stage but patients with significant medical comorbidity, suffering from obesity, diabetes, high blood pressure and chain-smokers are at a higher-risk to infection. Delayed breast reconstruction can also involve more complications than immediate reconstruction because skin surface area needs proper restoration. 

Some of the risks associated with Breast reconstruction surgery are as follows:

  • Heavy bleeding
  • Pulmonary complications
  • Scarring
  • Blood clots
  • Infection at the surgery site
  • Risks associated with incision and anesthesia 
  • Slow process of wound healing
  • Getting tired easily 
  • Fluid buildup in the breast or the donor site
  • Swelling and pain around the breast area

There is a possibility of various problems after breast reconstruction surgery and they may include: 

  • Tissue death (necrosis) of all or part of a tissue flap, skin, or fat
  • Numbness or changes in nipple and breast sensation
  • Loss of muscle strength
  • The need for more surgery in case of further medical complications
  • Problems with a breast implant, such as rupture, movement, leakage, and scar tissue formation 
  • Uneven breasts in case of loss of weight and leakage of the implant fluid
  • Hardening and changing shape of the breast implant

Types of Breast Reconstruction Techniques

There are two main techniques for Breast Reconstruction that include:

1. Tissue Expander-Breast implants: 

This is the most important technique for breast implants in which a surgeon inserts a tissue expander, a temporary silastic implant into the major pectoralis muscle of the chest wall. The pectoral muscles may be released along its inferior edge to allow the expander at the edge of thinner lower pole to cover the soft tissue area. When implantation is done properly, it helps to improve both functional and creative outcomes of implant. Many women consider this breast implant painful, but they are often pleased with the result.

Tissue Expander-Breast implants

2. Tissue Flap reconstruction: 

The second most important technique is Tissue Flap reconstruction. This method uses tissues from other parts of the patient's body, such as the back, buttocks, thigh or abdomen. Taking tissue from the abdomen is called a Tram flap, whereas tissue taken from the back is known as Latissimus dorsi flap. This process may be completed by leaving the donor tissue connected to the original site to retain its blood supply or it may be cut off and new blood supply is provided.

Sometimes many women consider nipple reconstruction during the mastectomy in order to lower the chances of cancer returning. Nipple reconstruction is done after breasts reconstruction is complete and is usually done with the help of local anesthesia. Tissue is taken from either the back or abdominal flap to complete the nipple reconstruction.

Tissue Flap reconstruction

Benefits of Breast Reconstruction

A woman might choose to have breast reconstruction because of the following reasons:

  • Pleasing and gorgeous shape of her breast
  • Makes her chest look more balanced and attractive when she is wearing a bra or swimsuit
  • Offers variety of options to customize to woman's need
  • Permanently regaining her breast shape
  • Only a single scar under or on the breasts which can fade over time
  • Breasts reconstruction brings in more confidence in her personality 

However, breasts reconstruction is always accompanied by scarring, numbness and loss of sensation. Advancement of technology in the field of medicine has reduced the amount of scarring to some extent. Talk to a doctor and discuss what are the necessary medications to overcome numbness and other possible complications post surgery.

Things to be kept in mind before a breast reconstruction surgery

Some of the important factors to be kept in mind while making a decision about breast reconstruction should include the following:

  • Is it possible to have a permanent breast shape after surgery? 
  • How much time it requires to resume normal activities?
  • Is financial issue a major concern for reconstruction surgery? 

Factors Influencing Breast Reconstruction Surgery

Below are the factors that influence breast reconstruction surgery:

1. Cancer stage: 
In general, women diagnosed with stage I or stage II breast cancers that choose mastectomy based on a biopsy are less likely to need radiation therapy or other treatments after mastectomy. This is often the best option for them because it combines the mastectomy and reconstruction into one surgical procedure. 

2. Decision-making: 
Getting a breast cancer diagnosis can be a stressful experience. Making decisions about mastectomy and other related treatments can leave you emotionally drained. The thought of making decisions about the type of reconstruction to have and when to have it might be very challenging.

3. Overall health condition:
 If a woman is suffering from diabetes, circulatory problems or a bleeding disorder, then the doctor may advise her to recover completely from mastectomy before she can have reconstruction. However, they can still be eligible for immediate reconstruction. This decision has to be made on a case-by-case basis. 

Usually many women are likely to have emotional difficulties after surgery for breast cancer and breast reconstruction. Even after several months, many women find it helpful to talk about their feelings and ask about things that worry them.
A breast care nurse is probably the first source of support, one can talk to a nurse, and they will walk you through many worries and put your mind at rest. Women who have already been through similar kind ofbreast surgery can also be a great help. 

For information and guidance, follow ElaCancer blog. Find Best Cancer Doctor, Cancer Treatment & Top Cancer Hospital by connecting with our specialists. You can reach us at +91-8929020600


Dr. Jaydip Biswas

About the Author

Medical Oncologist, Surgical Oncologist
Dr. Jaydip Biswas is a Surgical Oncologist and Cancer specialist at Chittaranjan National Cancer Institute in Kalighat, Kolkata. Dr. Jaydip has completed his MBBS from RG Kar Medical College and Hospital, Calcutta University in the year 1981 and MS in General Surgery from University College of Medicine, Calcutta University in the year 1986. Further, he pursued DMRT (Diploma in Medical Radiotherapeutics) from University College of Medicine, Calcutta University in the year 1989. He has a Fellowship of the Royal College of Surgeons of Edinburgh. Dr. Jaydip Biswas specializes in Bilateral Orchiectomy, laparoscopic prostatectomy, Lymph node dissection procedure, Mammoplasty surgery, Flap surgery and Tissue expansion procedure. Dr. Jaydip Biswas has got a gold medal in recognition and appreciation of contribution rendered towards community welfare in the year 1995 and 'Vashisht Chiketsk Award' in 1996. Dr. Jaydip Biswas was awarded with 'Bharat Vibhushan Samman Puraskar' in the year 2013 and 'Mother Teresa Excellence Award' in 2014. Dr. Jaydip has also got 'Rajiv Gandhi Education Excellence Award' in the year 2012 and 'Lifetime Education Achievement Award' in 2013. Dr. Jaydip has a practicing experience of more than four decades in the field of oncology. Book a FREE appointment with Dr. Jaydip Biswas at Elacancer.com.
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SOURCES AND REFERENCES:

  1. What is breast cancer? breasts cancer, Elacancer - 2018
  2. Mri imaging test to detect cancer breast cancer diagnosis, Elacancer - 2018
  3. Targeted therapy for cancer breast surgery, Elacancer - 2018

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Sanat Vaisakhi
Nov. 17, 2018, 7:02 p.m.
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