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Breast Cancer? Know Your Options For Surgery!

Credit: cancerdotsc (via Flickr)
Credit: cancerdotsc (via Flickr)

Mastectomy is the worst nightmare a woman can have.  As if being diagnosed with cancer is not enough, removal of the breast plays havoc with a woman’s self-esteem.

Each year more than 250,000 women in America face breast cancer and many of them undergo breast reconstructive surgery. Why breast reconstruction?

There are a number of reasons women go for reconstruction of their breasts:

–         Because they cannot imagine their lives with a flat chest in place of a breast

–         To regain their original breast shape

–         To avoid having to use a padding inside the bra for the rest of their lives

Many women say that reconstruction helps with their self-esteem and body image. But the problem is that most women get this surgery done without even understanding what their options are or what they are getting into.

With a whole lot of choices to make, there is a growing concern that women are not being properly informed about all the treatment options available to them.  Most women are usually presented with “Okay, this is what we are going to do,” by the doctors.

According to the American Society of Plastic Surgeons’ report, almost 70 percent of breast cancer patients who are eligible for breast reconstruction procedures were not informed of the options for reconstruction that are available to them.

Some say that it is because of doctors’ hectic schedules that prevent them from discussing and explaining things to their patients. It may also so happen that the doctor does not mention a particular procedure to the patient, if he or she is not competent or trained in performing that surgery.

Whatever the reasons, every woman has the right to know the options. Let’s see what they are according to experts.

Planning Well In Advance

If you are planning on having reconstructive surgery, you will first have to discuss in-depth with your surgeon, who is experienced in breast reconstruction, even before you get a mastectomy done.  Planning well in advance will give you a chance to understand your options and allows the surgical team also to plan the best treatment for you.

Breast cancer experts recommend that the patient should try and slow down the process. According to a breast cancer expert at the University of Michigan Health System, “The median time from breast cancer diagnosis to surgery is two weeks. That’s way too fast. Breast cancer is not a medical emergency.  You have a period of time, certainly weeks, to make decisions.”  He tells patients to weight all their options and also get second opinions. He says, “Make no decisions in the first visit to the doctor.  Let me repeat: Make no decisions in the first visit.”

Decisions For Reconstructive Surgery

There are several factors that need to be considered before having reconstructive surgery.

–         Overall health

–         The stage of the breast cancer

–         The size of the natural breast

–         The amount of chest tissue available.  Thin women may not have enough tissue to make flap grafts.

–         Whether reconstruction needs to be done on one or both breasts

–         The type of reconstructive surgery

–         The size of the reconstructed breast

Types Of Surgery

–         Mastectomy: This means complete removal of the breast.

–         Lumpectomy/Segmental Mastectomy/Breast Conservation Surgery: Removing only part of the breast tissue.

Immediate or Delayed

–         Immediate breast reconstruction is done immediately after the mastectomy.

–         Delayed breast reconstruction means that it is rebuilt later.

The advantage of getting it done immediately is that the chest tissues are not damaged by radiation therapy or scarring and the resultant new breast looks better. It also means easier surgery. However, delayed reconstruction may be a good idea for women who will need radiation to that area even after the mastectomy. This is because radiation therapy given after the surgery can lead to problems.

Haste Is Waste

Experts say that sometimes the journey from diagnosis to surgery is initiated in haste by the patients themselves. According to one expert, “Many women have the reaction, ‘Get this cancer out before it kills me!’ They don’t realize it’s been there for years.

Even women doctors patients are said to make this mistake when they are affected with breast cancer.  A doctor cites an example of a lady doctor who had breast cancer. “”I had two patients who were physicians and they jumped the queue and had their mastectomies very quickly,” she remembers.”They didn’t wait for all the tests to come back, and when they did, the tests showed these women could have kept their breasts, but they had that operating room booked.”

Sometimes patients take the advice of only one surgeon. They don’t bother meeting the medical oncologist to check if chemotherapy is required and go by what their surgeon says, when in fact it is the medical oncologist that specializes in chemotherapy and not the surgeon.

Conclusion

American Society of Plastic Surgeons’ advises breast cancer patients to seek out information objectively with a clear head.  They are asked to read books, surf the internet, look at studies, and discuss with surgeons with high credentials. If you don’t need intensive surgeries, then you are asked to go for procedures that are less invasive and less painful.  Make the right choices by investigating all the options.  Even if your doctor doesn’t give you the options, you will have to find out and discuss with him or find a new surgeon who is open to discussions.

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