Five questions about Breast Reconstruction.
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1. Should breast reconstruction be discussed with every breast cancer patient?
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Yes. It is important that your doctor or health care specialist discuss the possibility of breast reconstruction. Information is a good way to decrease anxiety in any situation. To have a choice is comforting.
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2. Is breast reconstruction for every breast cancer patient? |
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No. The first goal of breast reconstructive surgery is for the patient to be tumor-free. If the surgical removal or the adjuvant treatment does not control the cancer, you are not a candidate.
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3. What is the best technique for breast reconstruction? |
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Every technique can offer a great result when used for the right patient. The best method depends on:
- personal health
- the clinical staging of the cancer
- the presence or possibility of radiation
- the size of the breasts and the amount of body tissue present for potential donor sites.
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A comparison of breast reconstruction techniques.
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Implant/Expander |
Pedicled TRAM or latissimus dorsi |
Free TRAM |
| Surgery |
1 or 2 shorter procedures, multiple visits for expansion, usally secondary surgeries required 5-10 years later. |
One longer procedure
(3-5 hours), permanent reconstruction, less secondary surgery |
One longer procedure
(4-6 hours), permanent reconstruction, less secondary surgery |
| Hospitalization |
1-2 days |
4-5 days |
4-5 days |
| Recovery |
2-3 weeks
multiple visits for expansion |
8-10 weeks |
6-8 weeks |
| Scars |
Mastectomy scar alone |
Mastectomy and donor site (tummy tuck or back) |
Mastectomy and donor site (tummy tuck) |
| Potential problems |
Breast hardening distorting shape and feel, 40% chance at 4 years, cause for secondary surgery |
Abdominal weakness or bulge, 20% chance of hardening or partial flap loss |
Less abdominal weakness or bulge, 2-5% chance of hardening or flap loss |
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4. When should breast reconstruction be performed? |
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At the time of breast cancer diagnosis. If you are healthy, the tumor is less than 4 cm, and the doctor can not feel lymph nodes in your axilla, then you should be offered immediate breast reconstruction. Immediate breast reconstruction is performed during the same surgery as the mastectomy.
If you are not a candidate for immediate breast reconstruction, delayed reconstruction can be performed if the tumor can be controlled with surgery, radiation and chemotherapy. |
5. How long should a breast cancer patient wait for breast reconstruction? |
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If you are a candidate for immediate breast reconstruction, it should be offered to you at the same time as your mastectomy.
If you desire delayed breast reconstruction, your doctor will advise you when your health and cancer treatment will allow for breast reconstruction. |
Our group would like to thank Dr. Nicolas A. Guay MD.FRCS(c) for kindly responding to our request to provide important information on Breast Reconstruction. We wanted to make this information available for the benefit of all who have questions regarding this procedure. Dr. Guay is a well respected surgeon in his field, and one of a very small group of surgeons who specializes in Plastic & Reconstructive surgery with the Ottawa Hospital. Dr .Guay can be contacted at:
Dr.Nicolas A. Guay MD.FRCS(c)
Plastic & reconstructive surgery
Chirurgie plastique & reconstructive
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1919 Riverside Dr., Suite 206
Ottawa, Ontario Canada
K1H 1A2
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Tel (613) 247-0889
Fax (613) 247-2073 |
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