Overcoming Misconceptions and Worries About Post Mastectomy Breast Reconstruction

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Breast Reconstruction Specialist Dr. Constance M. Chen outlines common misconceptions and offers tips for breast cancer patients

Dr. Constance Chen

For women with a breast cancer diagnosis, it's central for her physical and emotional recovery that she has comprehensive and accurate information about the various options available to her.

Imagine that you are blindsided with a cancer diagnosis and very soon thereafter, you are asked to make serious and important decisions about your treatment. According to Dr. Constance M. Chen, who specializes in breast reconstruction after mastectomy, this happens often. “When I meet a patient for the first time, she has often learned that she has breast cancer and knows that she has major decisions ahead,” says Dr. Chen.

According to BreastCancer.org, “in 2021, an estimated 281,550 new cases of invasive breast cancer are expected to be diagnosed in women in the U.S., along with 49,290 new cases of non-invasive (in situ) breast cancer.”

Although the rates of breast reconstruction continue to increase, a 2014 study found that less than 40% of women who undergo mastectomy elect to undergo immediate reconstruction. (http://bit.ly/1yHmckj Journal of the American College of Surgeons, December 6, 2014.)

Dr. Chen observes that “Many women feel that after completing treatment for breast cancer, breast reconstruction has a positive impact on their quality of life.” And yet she adds that more education is needed around breast cancer and breast reconstruction. Dr. Chen stressed the importance of overcoming common misconceptions

Five Top Misconceptions and Worries about Breast Reconstruction:

#1: Breast reconstruction is not possible after radiation or chemotherapy.
Radiation and chemotherapy may determine the timing and ideal type of breast reconstruction, but they do not rule out breast reconstruction altogether. While radiation may be considered a relative contraindication to breast implants, it is still usually possible to undergo breast reconstruction of some type. After radiation treatment, some patients may be told it is safer for them to undergo breast reconstruction with their own natural tissue.

#2: Breast reconstruction makes it harder to detect a breast cancer recurrence.
Numerous studies over many years have found no evidence that post-mastectomy breast reconstruction makes it harder to detect or treat a breast cancer recurrence. There is also no evidence that breast reconstruction increases the risk of breast cancer recurrence. The risk of breast cancer recurrence hinges on many factors such as the stage of the disease and the biological characteristics of the cancer.

#3: Immediate breast reconstruction is not possible, so it will be necessary to wait months for surgery.
Most women can have immediate breast reconstruction at the same time as their mastectomy. Often, immediate breast reconstruction yields the best aesthetic results because it allows the surgeon to preserve the skin, including the nipple and areola, and can help to minimize scarring. It can also reduce the number of additional surgeries.

#4: Breast implants are uncomfortable and look unnatural.
Breast implants above the pectoralis muscle are significantly more comfortable than breast implants under the pectoralis muscle. Depending on the mastectomy, breast implants can also look natural if the patient has undergone a nipple-sparing mastectomy. Breast implants are not the only option for breast reconstruction, however. Autologous reconstruction that uses your own tissue, usually taken from the abdomen, produces a breast that is soft, warm, and natural. In combination with skin and nipple-sparing mastectomy techniques, the best reconstructed breast today may be difficult to distinguish from a woman's original breast.

#5: Breast reconstruction is expensive and unaffordable.
In 1998, Congress passed the Women’s Health and Cancer Rights Act (WHCRA), a federal law that requires group health plans and individual health policies that cover mastectomy to also cover breast reconstruction. This includes coverage for all stages of reconstruction of the breast on which the mastectomy was performed as well as surgery and reconstruction of the other breast to achieve symmetry and balance. The WHCRA provides a vital baseline benefit in helping women recover from breast cancer and enables them to focus on getting well without unnecessary anxiety about the costs of breast reconstruction.

Dr. Chen adds that for women with a breast cancer diagnosis, “it's central for her physical and emotional recovery that she has comprehensive and accurate information about the various options available to her. That’s why it’s so important to correct misconceptions about reconstruction so that women can make the most educated decisions about her treatment options and future.”

Constance M. Chen, MD, is a board-certified plastic surgeon with special expertise in the use of innovative natural techniques to optimize medical and cosmetic outcomes for women undergoing breast reconstruction. She is Clinical Assistant Professor of Surgery (Plastic Surgery) at Weill Cornell Medical College and Clinical Assistant Professor of Surgery (Plastic Surgery) at Tulane University School of Medicine. http://www.constancechenmd.com

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