Mastectomy Patients Have Options

Breast reconstruction can make a significant difference in the quality of life of mastectomy patients, and many options regarding how the surgery is conducted are available.

"One of the myths about reconstruction is that the only option is to insert an implant," said Dr. Jeffrey Friedman, assistant professor of surgery at Baylor College of Medicine. "In truth, many different types of techniques are used."

Decisions should be based on a number of factors, including cosmetic results and recuperation time.

Dr. Friedman said implants can be used, along with a patient's own tissue and fat, to achieve the desired results. However, implants should not be used when the patient's therapy includes radiation.

"With implants, there might be changes in shape months after surgery. Using only tissue and fat, the results will be the same five years after surgery as they are a month after surgery," he said.

Dr. Friedman said certain myths about breast reconstruction have kept some women from having the surgery. Some of these misconceptions are:

• Women must wait two years after a mastectomy to have reconstruction. Dr. Friedman said that reconstruction can almost always be done at the same time as a mastectomy, and it's less complicated when the two procedures are perfomed at the same time. "There is no medical reason not to suggest reconstruction at the time of surgery for early-stage breast cancer," he said.
  
  
• Reconstruction will delay chemotherapy treatments or cause wound-healing problems. Not so, said Dr. Friedman. The risk of wound-healing complications or a delay in chemotherapy is the same whether a patient chooses a mastectomy or a mastectomy with reconstruction.
  
  
• Reconstruction will hide a local recurrence of breast cancer. "Clearly not. In almost all cases, women who have a recurrence have it in the skin of the chest that's left behind after a mastectomy. So, whether you have reconstruction or not, it should be easily detectable," he said.

Dr. Friedman said it is important for women to be aware that there is no one course to follow and to carefully consider all options when having a mastectomy for early-stage breast cancer.

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©2006 Texas Medical Center

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