Breast cancer affects approximately one in eight women world-wide. No cancer has been more widely researched with respect to its psychological impact on the sufferer.
A woman’s breast is intimately associated with femininity , sexuality & self esteem. Breast reconstruction is an important cosmetic & reconstructive option pursued by most women after undergoing mastectomy. With proper preoperative counseling, as part of the informed consent , the patient has a role in the decision making process – i.e. both the type of procedure to be done to remove the cancer as well as the reconstructive options should be discussed preoperatively.
Various reconstructive options are available to patients after mastectomy. Reconstruction may be done immediately or as a delayed procedure , depending on the type and stage of the cancer . There are significant benefits to immediate reconstruction in that the pain of disfigurement and loss of femininity that accompany mastectomy are lessened ; there is less psychosocial morbidity & less depression.
There are generally two stages to breast reconstruction:
- Creation of a breast mound
- Nipple-areola reconstruction & size matching of the contra-lateral breast.
Options for breast mound reconstruction:
- Breast implant alone ( if there is sufficient skin)
- Tissue expansion ( to create more skin) followed by insertion of an implant
- Latissimus dorsi muscle & skin flap ( for extra skin) plus implant
- TRAM flap
All of the above options should be discussed with you ,the patient, preferably before the mastectomy is performed & your suitability for & the pro’s & cons of each option explained.
The second stage – nipple reconstruction – is usually done about 3 months after the breast mound reconstruction.
