October is National Breast Cancer Awareness month, so this is a great time to touch on the topic of breast reconstruction. Treating breast cancer is a team effort: the oncologist is the specialist in the treatment of cancer. The breast surgeon performs the actual operation to get rid of the cancer. The pathologist looks at the cancer cells under a microscope and tests them for hormone receptors to help guide treatment. If radiation therapy is done, there is another team of radiation specialists to coordinate that part of treatment. And the plastic surgeon does the reconstruction.
In the best case scenario, you get to meet all these people (except maybe the pathologist- they’re more behind-the-scenes) within a week or two of your diagnosis. As a plastic surgeon who does breast reconstruction, I wanted to share some aspects of breast reconstruction that you might not be aware of.
1. Breast reconstruction can be done immediately, or years after treatment for cancer. Some women don’t have the chance to meet with a plastic surgeon, or just aren’t ready to think about having a reconstruction done at the time of their initial cancer surgery. But just because you’ve waited doesn’t mean it’s too late. Reconstruction can be done at any time. Some cancer treatments, like radiation, will delay a reconstruction. But it’s never too late.
2. Breast reconstruction isn’t only for the breast with cancer. Sometimes surgery is needed on the unaffected breast to make it more symmetric with the reconstructed breast. This may mean making the unaffected breast smaller (a breast reduction) or lifting it up (a mastopexy).
3. You don’t have to have a mastectomy to need a reconstruction. Even breast-conserving operations such as a lumpectomy can leave you with mismatched breasts. Options to improve the look may include adding tissue or an implant to the affected breast, or altering the unaffected breast (see #2 above).
4. Breast reconstruction is covered by insurance. This has actually been required by law since 1998, when the American Society of Plastic Surgery (ASPS) worked with federal regulators to require insurance companies to cover breast reconstruction. They also require insurance companies to cover procedures on the unaffected breast such as a reduction or lift if they are necessary for symmetry.
5. Your reconstruction surgeon will be a friend for life. Plastic surgeons who do breast reconstruction generally see their breast cancer patients every year to see how things are going and to help monitor for new or recurrent cancer. This means another person in your corner looking out for you. This long-term relationship with patients is one of the reasons why I love doing breast reconstruction.
Here are some excellent resources if you would like to read more about breast reconstruction:
Have you had any experiences with breast reconstruction or breast cancer you would like to share?