BREAST RECONSTRUCTION
A woman’s image of herself is often dramatically changed by breast surgery. This may not affect some women much at all, but for many it is a significant and difficult change to come to terms with, and can be the cause of psychological distress. The impact of breast surgery can be lessened by getting explanations, realistic impressions of what the available options are, and supportive counselling if necessary, preferably before surgery.
In the past, the only help available to women to overcome the physical changes of breast surgery was removable padding, worn in a bra. This type of breast prosthesis is still widely used by women waiting for reconstructive surgery, or on a permanent basis.
However, breast reconstruction is becoming a much more widely used method of helping women cope with the effects of mastectomy. Surgeons are tending to consider early reconstruction, and tailor their mastectomy technique to allow for a better end result. Women will usually have reconstructive operations some time after the mastectomy.
Reconstruction options should be discussed before a mastectomy. Different techniques can be used. Some involve inserting a prosthesis, which in this case is a bag of fluid, under the skin, replacing the breast tissue. There has been some controversy about silicon implants and their safety, but they have been widely used in post-mastectomy breast reconstruction. Modern implants are often combination implants, comprising a silicon lining filled with salt water, and thought to cause less potential problems than silicon filled implants.
Surgeons are also using other techniques in some centres, which involve constructing a breast shape out of actual skin and muscle taken from elsewhere on the body. This is like being your own donor, as a part of your own body is used to construct a new breast. Results from this type of surgery are often very good.
So, unfortunately, modern methods have not yet made a great impact on the death rate from breast cancer, but this looks likely to happen in the future. What today’s doctors can offer women with breast cancer is earlier diagnosis, less-disfiguring surgery, the option of surgical reconstruction, and hopefully a better understanding of the effect of this disease on the whole person, not just the breast.
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