October is Breast Cancer Awareness Month, and with that there are a number of activities this month aiming to fundraise for breast cancer research and as well as raise awareness about detection and prevention. In 2011, Canada launched the first BRA Day (Breast Reconstruction Awareness Day). BRA Day is unique as breast reconstruction closes this loop on breast cancer.
BRA Day will occur annually on the third Wednesday of October to raise awareness about breast reconstruction. The mission of BRA Day is to “develop and advance an internationally recognized day that promotes awareness and access to post-cancer breast reconstruction surgery.” Thus far, 20 plus countries and more are participating. As a plastic surgeon and a woman, I encourage everyone to discuss breast reconstruction because it is an integral part of the recovery process after cancer for many women.
Here are some FAQs that may help:
A personal CHOICE
Breast reconstruction is an option available to most women confronted with the physical changes following mastectomy. While breast reconstruction is considered elective surgery, undergoing breast reconstruction can have profound emotional and practical benefits. It is also important to bear keep in mind that breast reconstruction does not interfere with the treatment of breast cancer nor or surveillance for recurrence. It can, however, help to enhance your confidence and self-image after mastectomy.
The decision to have breast reconstruction is a personal one, to be decided by you and your loved ones. It is paramount to understand that not all patients are candidates for all types of reconstruction. The type of reconstruction you undergo will be decided by you and your surgeon, depending on your particular needs, anatomy, and previous treatments.
Many women wonder what a reconstructed breast looks and feels like. For instance, ‘Will it look the same as my previous breast? Will it match my other breast?
Does the nipple have feeling?’ Unfortunately, while there are many techniques of breast and nipple reconstruction, none of them will be able to give you back the exact same breast you were born with. It is important to realize that after a mastectomy, the only tissue remaining on the chest wall is muscle and a thin layer of skin. Your plastic surgeon will be creating an entirely new breast from these tissues. The breast often feels and looks different from the original breast and procedures to make it look more similar to the opposite side may be required as you will read below.
In addition, most women find the skin of the chest wall has less sensation after a mastectomy. Nerves that were removed during the mastectomy cannot be replaced and the loss of feeling is unfortunately permanent. However despite these limitations, most women who undergo breast reconstruction derive immense benefits from the procedure. These include feelings of regained wholeness and femininity, as well as practical benefits such as eliminating the need for wearing a cumbersome breast prosthesis and achieving spinal balance.
There are 3 main steps in any breast reconstruction:
- The creation of a new breast mound
- Touch-ups of the reconstruction, and possible modification of the opposite breast (lift, reduction) in patients having a mastectomy of one side (optional)
- The creation of a new nipple and areola (optional)
Types of breast reconstruction:
There are three main types of breast reconstruction.The first type of reconstruction uses an implant filled with silicone gel to recreate the breast mound. A second option is to build a breast mound using tissue “borrowed” from another part of your body. The last type of reconstruction combines the use of both “borrowed” tissue from your back as well as an implant.
Your plastic surgeon will discuss these methods with you and counsel you as to which option is best suited for you based on your physical and treatment characteristics.
Who can have reconstruction?
Most women who are having or have had a complete or partial mastectomy (removal of all or some of the breast tissue and nipple) are candidates for breast reconstruction. If you have had, or will need radiation therapy to the breast, it may influence the type of reconstruction, and when you can have it. Some patients will need chemotherapy after their mastectomy, and this too can affect the timing of your reconstruction.
When to begin reconstruction?
Reconstruction can be either immediate (at the same time as the mastectomy) or delayed (at a later time). This decision may be dictated by the characteristic and stage of the breast cancer, and will be made together with your breast surgeon. In many cases, immediate reconstruction is a reasonable and safe option.
Don’t feel Guilty
I see many women who feel guilty or ashamed about wanting breast reconstruction. (In the sentence that follows please change double quotations to single) Many patients will come in for a consultation to discuss breast reconstruction, and they may say, ‘I’m not vain,’ or ‘my husband says he doesn’t care if I have breasts,’ or ‘I feel guilty for wanting reconstruction, after putting my family through so much already.’ Breast reconstruction is not something that women should be ashamed of for wanting or feel guilty for having. It is not vanity. It is about recovery and healing.