Breast cancer is most commonly treated with either a lumpectomy or mastectomy.

• A lumpectomy means removal of the cancer and some of the tissue that surrounds it. It is also called breast conserving surgery.
• Removing tissue around the cancer helps ensure that all of the cancer has been removed.
• After a lumpectomy, there is usually enough breast tissue left for the breast to have a relatively normal shape. Therefore, a breast reconstruction is not typically needed.

A mastectomy refers to the removal of the entire breast.

• Depending on a number of factors, lymph nodes (glands) in the underarm area may need to be removed as well.
• Radiation after a mastectomy used to be rare. In recent years, it has become more common.
• Whether or not radiation is given is an important issue when deciding on the timing of a breast reconstruction.

Breast reconstruction uses either:

• Tissue from your own body
• Saline or silicone breast implants
• A combination of both

Some patients are suitable candidates for either procedure. Other patients have anatomy that favors one type of reconstruction over the other.

A breast reconstruction after the removal of a breast is a personal choice and an optional one.

• Your surgeons can offer information on whether or not you are a suitable candidate for the surgery and what the risks or rewards might be. He or she can also tell you what type of reconstruction would be best for you.
• A breast reconstruction can be done right after a mastectomy or at a later date.
• If an unexpected amount of breast tissue is removed during a lumpectomy or partial mastectomy, reconstruction can be considered.

Breast reconstruction is an option for women who want to restore the appearance of the breast after a mastectomy. Immediate breast reconstruction surgery means that the surgeon will begin to rebuild the breast right after the breast tissue is removed.

• Skin from your breast may be preserved and you will have the shape of a breast when the surgery is complete.
• Sometimes additional reconstructive procedures are needed to further shape the breast.

Delayed breast reconstruction surgery means waiting to begin rebuilding the breast.

• You can wear a breast prosthesis in a bra until the rebuilding is completed.
• A delayed breast reconstruction may be recommended for women who need radiation after a mastectomy. This is because reconstruction will make the delivery of the radiation more difficult. It can also interfere with the healing process.
• There may be an increased risk of complications for women who are obese, use tobacco products or have uncontrolled diabetes. Therefore, breast reconstruction may be delayed for those women.

It is best to speak with a plastic surgeon before your breast-sparing surgery or mastectomy. He or she can help you understand your options and what your breasts might look like after surgery. To get a full range of opinions and perspectives, you may want to consider input from a variety of healthcare providers, including:

• Your primary care physician (PCP)
• A medical oncologist (a doctor who specializes in the treatment of cancer)
• A surgeon with experience in breast cancer
• A radiation oncologist (a doctor who specializes in treating cancer with radiation therapy)

Some states and insurance policies define coverage for breast reconstruction. This may include time limits on coverage of second and third reconstructive procedures.

If your healthcare provider recommends a breast reconstruction after a mastectomy, prior to surgery tell them about any medications you are taking (including over-the-counter medications and supplements). Ask about specific instructions you should follow before and after the surgery. These include:

• Medications you should not take before the surgery, such as blood thinners
• Regular medications you should continue to take on the day of your surgery
• How many hours you should stop eating and drinking before the surgery

If you are a smoker, you should quit smoking because it can interfere with your recovery. If you smoke, many plastic surgeons will not perform a breast reconstruction using your own tissue.

During your surgery, you will receive anesthesia to keep you comfortable and pain free.

• General anesthesia is the most common type of anesthesia for a mastectomy and/or breast reconstruction.
• With this type of anesthesia, you are put into a deep sleep and are unable to see, hear, or feel anything.

It is important to remember that the total cost of this care path does not include all possible medications, lab work or imaging studies. Those charges can add up. If your healthcare provider recommends any lab work or imaging studies, you may need to search for their costs separately.

What should I ask my healthcare provider before having a breast reconstruction?

• What are my treatment options for breast reconstruction surgery? Why are you recommending one option over another? What are the benefits and risks of each?
• Should I have my breast reconstruction done immediately after my mastectomy, or should I wait? What are the advantages and disadvantages of each?
• What will my breasts look like after breast-sparing surgery (or mastectomy)?
• What can I expect if I decide not to have this surgery?
• What is your experience in doing this type of surgery?
• What are the possible complications after a breast reconstruction? What is your complication rate?
• What results do you expect from this surgery?
• How long will it take me to recover? How will I feel after the surgery? Will I have to modify my activity?
• What types of normal breast changes should I expect to occur over time?
• Will I be receiving other treatments before or after my surgery?

It is a good idea to have a spouse, friend, or relative accompany you to consultation visits, in order to be a note-taker for you.

• Often, right after the diagnosis of breast cancer, it is difficult to retain everything that you are being told.
• Having someone along can improve your understanding of this rather complicated process.

Do not forget to arrange for transportation to and from the facility and for help at home.

Source UHC.com

Also known as:

Reconstruction

Mastectomy

Breast Reconstruction After Mastectomy

Breast Reconstruction

Breast