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 a decision. 

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:

·      Your overall 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

·      Your insurance 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 body

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).

Immediate breast 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 reconstruction.

·      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 healing.

·      You need 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. 

Source: www.cancer.org/cancer/breastcancer/moreinformation/breastreconstructionaftermastectomy/breast-reconstruction-after-mastectomy-toc.