Tag Archive for breast cancer

Reconstructive Breast Surgery

Introductory Note: As always, the information given here is for general informational purposes only. All women about to undergo treatment for breast cancer should consult their health care team about the options appropriate for their particular medical situation.

The American Cancer Society estimates that about 192,200 women in the United States will be diagnosed with invasive breast cancer in 2001. Many of those women whose treatment involves mastectomy (surgical removal of a breast) will have the option of reconstructive breast surgery. According to the American Society of Plastic Surgeons (ASPS), “Nearly 79,000 breast reconstruction procedures were performed last year, a 166 percent increase since 1992.”

The ASPS says that most women who have mastectomies are candidates for breast reconstruction. So the first choice a woman facing a mastectomy will have to make is whether or not to have reconstructive surgery. Some women choose not to have reconstructive surgery and decide instead to use a prosthesis, a breast-shaped form that can be inserted into a bra.

Women who decide to have reconstructive surgery will then have to consider whether to have the reconstruction done at the same time as the mastectomy or later. Some women may choose to wait because they don’t feel they can adequately consider all the reconstructive options while coping with a cancer diagnosis and treatment regimen. Also, delayed reconstruction may be necessary for women who will be having radiation therapy after their mastectomy. But the ASPS says that women who want breast reconstruction are increasingly choosing to have it done as the time of mastectomy.

When the two surgical procedures are done at the same time, a surgeon will perform the mastectomy and a plastic surgeon will perform the reconstruction. Several reconstructive techniques are available, including skin expansion followed by an implant or reconstruction with tissue from another part of the patient’s body such as the back, hip, abdomen, or buttocks.

The most common breast reconstructive procedure is skin expansion followed by insertion of an implant. In this procedure, the plastic surgeon inserts a balloon expander under the skin and chest muscle. The doctor then periodically injects salt water into the expander so the skin covering the expander will stretch. It may take several weeks or months for the skin to stretch adequately. Once the skin has expanded, the expander is removed and an implant is inserted. Some expanders are designed to be left in place as the permanent implant.

Other implant approaches involve using a flap of skin from another part of the patient’s body to create a pouch into which an implant can be inserted. In some cases tissue from the patient’s body can also be used to create the breast mound, eliminating the need for an implant.

After the initial reconstructive operation, the plastic surgeon may, if a woman desires, perform another procedure to construct a nipple and areola (the dark circle around the nipple). But a reconstructed breast will not have the same sense of feeling as the original breast. Also, a reconstructed breast may be undetectable when a woman is clothed, but it will always be obvious when she is nude.

The Women’s Health and Cancer Rights Act of 1998, a federal law, requires that medical insurance plans cover the cost of breast reconstruction and alteration of the other breast for symmetry for women who have had a mastectomy.

Breast Cancer Awareness Month

According to the Susan G. Komen Breast Cancer Foundation, during the year 2000, 182,800 women will be diagnosed with breast cancer, and 40,800 women will die of breast cancer. Breast cancer is the leading cause of cancer deaths among women ages 40-59 and is second only to lung cancer in cancer deaths. The breast is the leading cancer site among American women.

Breast Cancer Awareness Month originated in October 1985, when the American Academy of Family Physicians and Cancer Care, Inc., distributed brochures, spoke to news reporters, and testified before a U.S. Congressional committee about the need for increased access to mammography. Today, the Board of Sponsors of National Breast Cancer Awareness Month comprises 17 national public service organizations, professional medical associations, and government agencies working to raise awareness and provide access to screening services.

In conjunction with Breast Cancer Awareness Month, National Mammography Day has been held on the third Friday in October since 1993. On National Mammography Day, or throughout October, radiologists provide discounted or free screening mammograms. In 1999, more than 2,200 American College of Radiology (ACR) accredited facilities took part.

In honor of Breast Cancer Awareness Month, has introduced a section entitled Breast Power. “Having breasts is an experience all women share, everything from buying their first bra to breastfeeding to facing the risk of breast cancer. We must acknowledge these ‘breast experiences’ and understand the impact they have on our lives and sense of self,” the mission statement proclaims.

One part of this new section is a cartoon featuring a superhero named Lacey Brazeer. “Whether she’s battling the body-image blues or combating crass comments and cleavage-vision, you’ll be glad Lacey is on your side,” the site’s mission statement further states.

Exactly who is this Lacey Brazeer? “Lacey spends her days as a mild-mannered marketing associate for Matracon, a women’s apparel company,” according to the introduction of this character. But “Breast Power is what this women’s champion is all about.” Further, “like most superheroes, Lacey Brazeer is strengthened by her secret weapon…Breast Power, an invigorating way of looking at life that she wants to help every woman achieve.”

But not everyone finds this cartoon superhero inspiring, as a check of the message boards on the Breast Power site soon reveals. And over at Salon, the online magazine that issues commentary on everything, Andrew Leonard lamented the first episode of Lacey Brazeer in a September 19, 2000, article entitled “Superbreasts to the Rescue!”

“With the appearance today of Women’s new cartoon superhero, Lacey Brazeer, the women’s Web has now officially struck rock-bottom. It is not only hard but actually painful to try to imagine something that might be more insulting to the intelligence of a person of any gender than ‘door-busting, case-cracking, butt-kicking, breast-powered’ superhero Lacey Brazeer,” Leonard says.