Breast reconstruction following breast cancer

Breast cancer is one of the leading cancers in the western world. Cancer treatment commonly requires surgical excision with a parallel form of systemic treatment, such as radiotherapy. Specific to breast cancer, a mastectomy involves total or partial removal of the breast tissue and surrounding structures and was first performed in the late 1890‘s. Since this time, many variations have been developed and less invasive forms of surgery such as lumpectomy may be performed on suitable candidates. This is when an incision is made and the small breast tumor is removed without removing significant amounts of breast tissue.

Following radiotherapy and mastectomy, patients may undergo immediate breast reconstruction therapy. However, immediate breast reconstruction is better suited to women that do not require adjuvant radiotherapy. Many surgeons agree that delayed breast reconstruction is a safer alternative and allows the flexibility to later choose autologous (tissue taken from another part of their body) or heterologous (tissue from a different source or silicone/saline implant) reconstructive techniques.

In Australia, the cost of reconstructive surgery followed by cancer is covered by Medicare. However, only an estimated 20% of women choose to undergo breast reconstructive surgery following surgical oncology. Reports state that breast reconstruction surgery allows women to take control of their appearance and regain a sense of femininity to move on psychologically from treatment by removing the physical evidence of having cancer.

The surgical complexity and recovery time of breast reconstruction is heightened in irradiated tissue. Delayed healing, fibrotic tissue formation, necrosis and flap rejection are all possible and are relevant factors when determining suitable candidates for specific forms of BR surgery.

In the next blog post the effects of radiotherapy on the skin will be discussed, followed by a detailed explanation of types of reconstructive procedures of the breast following cancer.

 

Marnina Diprose holds a Bachelor Health Science in Dermal Therapies, a Diploma of Beauty Therapy and a Vocational Certificate of Laser and Light. Marnina has a strong passion in scar revision and holistic approaches to patient care. For media inquiries or if you have an interest in blog contribution please email info@arozedermaltherapies.com.au


References:

Claben, J., Nitzsche, S., Wallwiener, D., Kristen, P., Souchon, R., Bamberg, M., & Brucker, S.     (2010). Fibrotic Changes after Postmastectomy Radiotherapy and Reconstructive Surgery in     Breast Cancer. Strahlentherapie und Onkologie, 186(11), 630-636.

Duxbury, P., Gandhi, A., Kirwan, C., Jain, Y., & Harvey, J. (2015). Current attitudes to breast     reconstruction surgery for women at risk of post-mastectomy radiotherapy: A survey of UK     breast surgeons. The Breast, 24(4), 502-512.

Health care in Australia. (2014). Cancer Council New South Wales. Retrieved from http://www.cancercouncil.com.au/87283/b1000/understanding-your-rights-46/health-care-in-australia/#medicare

James, R., McCulley, S., & Macmillan, R. (2015). Oncoplastic and reconstructive breast surgery in     the elderly. British Journal Of Surgery, 102(5), 480-488.

McKean, L., Newman, E., & Adair, P. (2013). Feeling like me again: a grounded theory of the role     of breast reconstruction surgery in self-image. European Journal Of Cancer Care, 22(4),     493-502.

Patani, N. & Carpenter, R. (2010). Oncological and Aesthetic Considerations of Conservational     Surgery for Multifocal/Multicentric Breast Cancer. The Breast Journal, 16(3), 222-232.

Van Maaren, M., de Munck, L., de Bock, G., Jobsen, J., van Dalen, T., & Linn, S. et al. (2016). 10     year survival after breast-conserving surgery plus radiotherapy compared with mastectomy     in early breast cancer in the Netherlands: a population-based study. The Lancet Oncology,     17(8), 1158-1170.

 

 

 

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