Breast Cancer Surgery Options
Each October we are bombarded with breast
cancer awareness campaigns, resulting in significant strides in earlier breast
cancer detection. However, studies have shown that women facing breast cancer
surgery are not always made aware of all their options. There has been little
focus on awareness of surgical options and the breast reconstruction process.
This might seem improbable, but I'm living proof that there is a gap in
knowledge about surgical options.
When women are panicking from a breast cancer
diagnosis, most won't spend time researching options. Since surgical techniques
vary by hospital, it becomes more critical for proactive education. Breast
Reconstruction Awareness Day (BRA Day) was created to address the educational
gap. On Wednesday October 15, 2014 the third annual BRA Day will take place.
In regards to surgical options, lumpectomy is
the least invasive option and it's a very common technique. In this technique,
only the tumor is removed and as much remaining breast tissue as possible is
left intact. However, depending on the tumor size and location, removal of the
cancer might leave a noticeably deformed breast.
If more extensive surgery is required, the
entire breast is removed, known as mastectomy. In this case, there then becomes
a choice of whether the patient wants to remain without a breast or wants a new
one to be created. Building a new breast is known as reconstruction and is
performed by a Plastic Surgeon working in conjunction with the Breast Surgeon,
who extracts the cancer. The procedures might be able to be completed during
the same surgery or reconstruction may require an additional surgery later.
In the event that the patient chooses
reconstruction after her mastectomy she may have multiple options in an
ever-evolving process, thanks to our donation dollars and continued medical
research.
The traditional reconstruction method entailed
placing an expander under the skin during the mastectomy surgery. The expander
is essentially an empty balloon. After the patient has recuperated from her
surgery, the doctor will gradually inflate the balloon over several sessions,
until the skin has been stretched out to the desired size, at which time the
expander will be exchanged with an implant or other body tissue during a second
surgery. A nipple can be added later, using flesh or a 3-D illusion tattoo,
along with a tattooed areola, if desired. It can be a lengthy process. Even
with the extended time and effort required, this option is still worthwhile for
many women.
Further evolution of reconstructive surgery
led to the "skin-sparing" mastectomy. In this case, the nipple and
areola are removed, but the remaining skin is left intact. The internal breast
tissue is removed and the cavity is filled with body tissue from another area
or an implant or an inflated expander during the initial surgery. The patient
would have a breast immediately, however, without a nipple or areola - both of
which can be added later, if desired. If an expander is used, it will have to
be swapped out with an implant or other body tissue later.
Nipple-sparing mastectomy, NSM, is currently
the most technically advanced reconstruction option. In this case, the entire
outer shell of the breast is left intact and only the internal breast tissue is
removed. The remaining void is filled directly with body tissue or an implant
or an inflated expander during the initial surgery. The result is similar to
the skin-sparing mastectomy, but it's a more aesthetically pleasing outcome as
the original nipple and areola are left intact.
All surgery options won't be offered at every
hospital. In addition, not everyone is eligible for every surgical option.
However, understanding the options that exist will allow a woman to make the
most informed surgical choice should the need ever arise.
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