Several members of MS/Cancer
Support Group have had breast cancer in addition to multiple sclerosis (MS).
Margaret Barney, facilitator for the group, led a discussion with the
organization’s members about breast reconstruction based on the following
article from the American Cancer Society.
This article is available
online at www.cancer.org/cancer/breastcancer/moreinformation/breastreconstructionaftermastectomy/breast-reconstruction-after-mastectomy-toc.
Breast reconstruction options
Several types of breast
reconstruction are possible for women who have had surgery to treat their
breast cancer. When deciding what type is best for you, you and your doctors
should discuss factors including your health and your personal preferences.
Take the time to learn about what options are available to you before you make
Choosing which type of breast reconstruction to have
If you’ve decided to have
breast reconstruction, you’ll still have many things to think about as you and
your doctors talk about what type of reconstruction might be best for you. Some
of the factors you and your doctors will need to take into account when
considering your options include:
health (including issues that might affect your healing, such as smoking or
certain health conditions)
The size and
location of your breast cancer
Your breast size
Whether you will
need treatments other than surgery for your cancer
The amount of
tissue available (for example, very thin women may not have enough extra tummy
tissue to use this area for breast reconstruction)
Whether you want
reconstructive surgery on one or both breasts
Your desire to
match the look of the other breast
coverage and related costs for the unaffected breast
How quickly you
want to be able to recover from surgery
The effects that
different types of reconstructive surgery might have on other parts of your
Your surgeon will review your
medical history and overall health, and will explain which reconstructive
options might be best for you based on your age, health, body type, lifestyle,
goals, and other factors. Talk with your surgeon openly about what you expect.
Be sure to voice any concerns and priorities you have for the reconstruction,
and find a surgeon that you feel comfortable with. Your surgeon should explain
the limits, risks, and benefits of each option.
Immediate or delayed breast reconstruction
You may have a choice between
having breast reconstruction at the same time as the surgery to treat the
cancer (immediate reconstruction) or at a later time (delayed reconstruction).
reconstruction is done, or at least started, at the same time as the surgery to
treat the cancer. The benefit of this is that breast skin is often preserved,
which can produce better-looking results. Women also do not have to go without
the shape of a breast.
While the first step in
reconstruction is often the major one, many steps are often needed to get the
final shape. If you’re planning to have immediate reconstruction, be sure to
ask what will need to be done afterward and how long it will take.
Delayed breast reconstruction
means that the rebuilding is started later. This may be a better choice for
some women. You might choose to delay breast reconstruction if:
You don’t want to
think about reconstruction while coping with cancer. If this is the case, you
might choose to wait until after your breast cancer surgery to decide about
You have other
health problems. Your surgeon may suggest you wait for one reason or another,
especially if you smoke or have other health problems. It’s best to quit
smoking at least 2 months before reconstructive surgery to allow for better
radiation therapy. Many doctors recommend that women not have immediate
reconstruction if they will need radiation treatments after surgery. Radiation
can cause problems after surgery such as delayed healing and scarring, and can
lower the chances of success. Flap reconstruction surgeries (using other body
tissues to create the new breast) are often delayed until after radiation.
Types of breast reconstruction procedures
There are several types of
reconstructive surgery available, and the reconstruction process sometimes
means more than one operation. Give yourself plenty of time to make the best
decision for you. You should make your decision about breast reconstruction
only after you are fully informed.
Two main types of operations
can be done to reconstruct the shape of your breast or breasts:
Breast implants (using silicone or saline inserts)
Tissue flap procedures (using your own body tissues)
Sometimes a combination of an
implant and flap procedure is used to get the best result.
In addition, nipple and areola reconstruction procedures can be done to help make the reconstructed breast look
more like the original breast.