Options for Breast Cancer Patients: January 3, 2012

About one in eight women in the U.S. will develop invasive breast cancer in her lifetime. That’s about 12% of the country’s female population. It also means a quarter of a million women will be considering their options. Many involve a mastectomy.

“There are several options that a woman can choose to do when having a mastectomy. She can either choose to have reconstruction at the time of the mastectomy or she can do it in a delayed fashion down the line if she has other treatments,” says Dr. William Wittenborn, a plastic surgeon on the Lee Memorial Health System medical staff.

In many cases, reconstruction begins at the time of surgery. Doctors can put an expander in to prepare the body for a breast implant. Some may choose to use their own tissue, taken from a donor site, instead of going with an implant.

“It’s your own tissue and so you don’t ever have to replace it. The disadvantages of it are the recovery time is actually significantly longer when you’re taking the tissue from another part of the body as opposed to just operating on the chest” says Dr. Wittenborn.

Another technique is the nipple-sparing mastectomy.

“Basically what we do when we do a nipple sparing mastectomy, is we make an incision underneath the breast of infra mammary crease, remove the breast underneath the skin envelope of the breast, keeping the nipple in place,” says Dr. Lea Blackwell, a breast surgical oncologist on the medical staff with Lee Memorial Health System.

Generally women with smaller breasts make the best candidates.

“It gives them a little bit more of like a feeling of being intact, a little less of a reminder about the fact that they had breast cancer,” says Dr. Blackwell.

A new technique is the oncoplasty, which is a breast preserving alternative performed on early stage cancer.

“An oncoplastic lumpectomy is simply a fancy kind of lumpectomy that takes into account what the breast looks like at the end of the procedure, that removes the breast tumor using plastic surgical operation such as a reduction operation. So you can take a large tumor out of a large breast and reduce it to a small round breast,” says Dr. Melvin Silverstein, a clinical professor of surgery at the University of Southern California.

Any decision should be based on the individual’s case in consultation with a doctor. A key factor is finding cancer early, which preserves more options.