Actress Christina Applegate’s public disclosure of her breast cancer, her decision to have a double mastectomy, and plans to go forth with breast reconstruction surgery, calls attention to the need for a medical “team” approach in the treatment and recovery from breast cancer.
“A decision to have breast reconstruction is a decision to have plastic surgery. And, that ought to be done by a plastic surgeon. This is what we train for and do everyday. Plastic surgeons have pioneered and refined all of the state-of-the-art techniques in breast reconstruction including implant approaches and autologous tissue (natural) transfers,” said Richard D’Amico, MD, president of the American Society of Plastic Surgeons (ASPS).
The methods for treating women with breast cancer have evolved and we are seeing scientific advancements in the treatment of this disease. These improvements can be attributed to a strong collaboration between medical specialties, in particular radiologists, pathologists, psychologists, general oncologic surgeons, medical oncologists, and plastic surgeons.
The ASPS says breast cancer patients should insist that their treatment be handled by a “team” of physicians, including plastic surgeons, with the appropriate expertise for each procedure and level of care. This, in turn, gives the breast cancer patient the best chance for positive outcomes.
“ASPS Member Surgeons are carrying out the cutting-edge research for constant outcomes improvement. Our members have the foremost training, education and experience in breast reconstruction, and should be a part of every breast care team,” said Dr. D’Amico.
Patients should not assume that anyone other than a board-certified plastic surgeon affiliated with an accredited facility is qualified to perform breast reconstruction. While technology has made breast cancer diagnosis, treatment, and reconstruction better than ever, it does not negate the need for medical expertise within each area.
According to a recent breast reconstruction study published in the Journal of Plastic and Reconstructive Surgery, 98 percent of elective mastectomy patients would have breast reconstruction again.
“That’s a success and satisfaction rate that should not be compromised,” said Dr. D’Amico.
According to ASPS statistics, more than 57,000 breast reconstruction procedures were performed in 2007.
******
Dr Chrysopoulo is board certified in Plastic and Reconstructive Surgery and specializes in breast reconstruction surgery after mastectomy for breast cancer. He and his partners perform hundreds of microsurgical breast reconstructions with perforator flaps each year including the DIEP flap procedure. PRMA Plastic Surgery, San Antonio, Texas. Toll Free: (800) 692-5565. Keep up to date with the latest breast reconstruction news by following Dr Chrysopoulo's Breast Cancer Reconstruction Blog.
******
Showing posts with label mastectomy reconstruction. Show all posts
Showing posts with label mastectomy reconstruction. Show all posts
Sunday, September 14, 2008
Sunday, August 3, 2008
98% Of Mastectomy Patients Would Have Reconstruction Again, Study Says
Satisfaction Rate 94% - 100%
Women who have breast reconstruction after an elective mastectomy are satisfied with their decision, have low complication rates and 98 percent would do it again, reports a study in July’s Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS). In addition, breast reconstruction after preventive mastectomy was as safe as or safer than reconstruction in women with breast cancer and had excellent cosmetic results.
“Breast cancer is a terrible diagnosis and decisions regarding treatment are never easy. This study shows that women with cancer in one breast who choose to have their other breast removed as a preventive measure are happy with their decision and a high percentage would do it again,” said Scott Spear, MD, study co-author and past ASPS president. “More remarkable is the 100 percent satisfaction level, as well as the 100 percent willingness to have breast reconstruction again, for the women who chose to have both breasts removed.”
The study examined 74 women who had preventive mastectomies and subsequent breast reconstruction between 2000 and 2005. Forty-seven patients had breast cancer in one breast and elected to surgically remove their other breast (unilateral prophylactic mastectomy). Twenty-seven patients did not have breast cancer, but chose to surgically remove both breasts due to a high-risk of developing breast cancer (bilateral prophylactic mastectomy). The cosmetic outcome was scored by 14 surgeons who looked at post-reconstruction photos and evaluated the result on a 1 to 4 scale (4 being an “excellent” result).
The study found that women who had a bilateral prophylactic mastectomy were 100 percent satisfied with their breast reconstruction and 100 percent of them would have the surgery again. Ninety-four percent of women who had unilateral prophylactic mastectomy were satisfied with their reconstruction and 96 percent of them would have reconstruction again.
The complication rate for reconstruction in women who had bilateral prophylactic mastectomy was 3 percent and 10 percent for those who had unilateral prophylactic mastectomy. Additionally, the study noted the cosmetic assessment for all patients was a score of 3 out of 4.
“These women look and feel the same or better and their risk of cancer has been taken off the table,” said Dr. Spear. “For women who know they are at risk, this option gives them the opportunity to be active about their health and appearance rather than reactive. They can have excellent cosmetic results, low surgical risk and a high level of satisfaction with their breast reconstruction. This is empowering for women.”
According to ASPS statistics, more than 57,000 breast reconstructions were performed in 2007, up 2 percent since 2006.
******
Dr Chrysopoulo is board certified in Plastic and Reconstructive Surgery. He is a breast reconstruction surgeon offering all types of breast reconstruction surgery after mastectomy for breast cancer. PRMA Plastic Surgery, San Antonio, Texas. Toll Free: (800) 692-5565. Keep up to date with the latest breast reconstruction news by following Dr Chrysopoulo's Breast Reconstruction Blog.
******
Women who have breast reconstruction after an elective mastectomy are satisfied with their decision, have low complication rates and 98 percent would do it again, reports a study in July’s Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS). In addition, breast reconstruction after preventive mastectomy was as safe as or safer than reconstruction in women with breast cancer and had excellent cosmetic results.
“Breast cancer is a terrible diagnosis and decisions regarding treatment are never easy. This study shows that women with cancer in one breast who choose to have their other breast removed as a preventive measure are happy with their decision and a high percentage would do it again,” said Scott Spear, MD, study co-author and past ASPS president. “More remarkable is the 100 percent satisfaction level, as well as the 100 percent willingness to have breast reconstruction again, for the women who chose to have both breasts removed.”
The study examined 74 women who had preventive mastectomies and subsequent breast reconstruction between 2000 and 2005. Forty-seven patients had breast cancer in one breast and elected to surgically remove their other breast (unilateral prophylactic mastectomy). Twenty-seven patients did not have breast cancer, but chose to surgically remove both breasts due to a high-risk of developing breast cancer (bilateral prophylactic mastectomy). The cosmetic outcome was scored by 14 surgeons who looked at post-reconstruction photos and evaluated the result on a 1 to 4 scale (4 being an “excellent” result).
The study found that women who had a bilateral prophylactic mastectomy were 100 percent satisfied with their breast reconstruction and 100 percent of them would have the surgery again. Ninety-four percent of women who had unilateral prophylactic mastectomy were satisfied with their reconstruction and 96 percent of them would have reconstruction again.
The complication rate for reconstruction in women who had bilateral prophylactic mastectomy was 3 percent and 10 percent for those who had unilateral prophylactic mastectomy. Additionally, the study noted the cosmetic assessment for all patients was a score of 3 out of 4.
“These women look and feel the same or better and their risk of cancer has been taken off the table,” said Dr. Spear. “For women who know they are at risk, this option gives them the opportunity to be active about their health and appearance rather than reactive. They can have excellent cosmetic results, low surgical risk and a high level of satisfaction with their breast reconstruction. This is empowering for women.”
According to ASPS statistics, more than 57,000 breast reconstructions were performed in 2007, up 2 percent since 2006.
******
Dr Chrysopoulo is board certified in Plastic and Reconstructive Surgery. He is a breast reconstruction surgeon offering all types of breast reconstruction surgery after mastectomy for breast cancer. PRMA Plastic Surgery, San Antonio, Texas. Toll Free: (800) 692-5565. Keep up to date with the latest breast reconstruction news by following Dr Chrysopoulo's Breast Reconstruction Blog.
******
Wednesday, July 16, 2008
Immediate Breast Reconstruction After Mastectomy is Safe, ASPS Study Says
Breast Reconstruction Does Not Impede Chemotherapy, Recovery or Diagnosis of Breast Cancer Recurrence.
Debunking the myth that women with locally advanced breast cancer must wait until after chemotherapy to have their breast reconstructed, a study presented at the Annual ASPS/PSEF/ASMS Meeting found that immediate free flap breast reconstruction for women with breast cancer is safe and psychologically beneficial.
The study, which followed 170 patients with locally advanced breast cancer, found that immediate reconstruction did not delay post-operative chemotherapy, prolong recovery or hinder the diagnosis of local cancer reccurrence.
"Losing a breast is traumatic," said ASPS Member James Watson, MD, and participating surgeon in the study. "As a board-certified plastic surgeon, I wanted to ensure that immediate breast reconstruction was safe for my patients and would make the healing process easier. The findings in this study will allow women to start healing sooner psychologically, knowing that their decision will not impede their physical progress against breast cancer."
The paper states that women participating in the study were pleased with their immediate reconstruction experience, indicating an immeasurable emotional benefit patients gain by having the reconstruction right away.
According to the findings, the majority of patients were either satisfied or very satisfied with their reconstruction and, if they had to, would have it done immediately after their mastectomy again. Also, the majority of women agreed they would recommend immediate reconstruction to a friend or colleague.
Through the study, Dr. Watson found that immediate free flap reconstruction - where the patient's own tissue is removed from the abdomen, buttocks or thigh regions and reattached in the breast using microsurgical techniques - resulted in similar complications and delays of post-operative chemotherapy to patients who delayed reconstruction. The most common postponement for patients was waiting for the wound to heal. However, the maximum delay was only three weeks, which did not have significant oncological impact on their post-operative therapy.
Also, while there were local recurrences of the cancer, physicians were able to diagnose the cancer's return quickly, resulting in no delay for additional treatment. Most local recurrences were located at the mastectomy scar or in the mastectomy flaps, which could be diagnosed by a physical exam and biopsy.
"An added benefit to reconstructing the breast immediately is that it's easier for the oncology surgeon to complete the mastectomy. Often, the breast cancer is so large or involves so much skin that the surgeon has to remove additional skin in the region, making it difficult to reserve enough tissue to close the wound," stated Dr. Watson. "With immediate reconstruction, the oncologic surgeon can eliminate more breast skin to ensure the cancer is removed and use the skin from the free flap procedure to close the wound."
According to ASPS 2001 statistics, more than 190,000 women were diagnosed with breast cancer and more than 80,000 women opted for breast reconstruction following a mastectomy.
Access to breast reconstruction following a mastectomy has increased due to the passage of the Women's Health and Cancer Rights Act 1998, proudly supported by ASPS, which mandated insurance coverage for breast reconstruction and the alteration of the opposite breast for symmetry for women who have undergone a mastectomy.
"With the finding that reconstruction right after mastectomy is safe, women can maximize their opportunity to not only heal physically but also psychologically right away," said Dr. Watson. "Before, women had to wrestle with their changed body image after losing a breast while physically recovering from their battle with cancer. Now, they don't have to delay the psychological healing process of beating breast cancer and celebrating that victory."
*****
Dr Chrysopoulo is board certified in Plastic and Reconstructive Surgery and specializes in breast reconstruction surgery after mastectomy for breast cancer. He and his partners perform hundreds of microsurgical breast reconstructions with perforator flaps each year including the DIEP flap procedure. PRMA Plastic Surgery, San Antonio, Texas. Toll Free: (800) 692-5565. Keep up to date with the latest breast reconstruction news by following Dr Chrysopoulo's Breast Reconstruction Blog.
******
Debunking the myth that women with locally advanced breast cancer must wait until after chemotherapy to have their breast reconstructed, a study presented at the Annual ASPS/PSEF/ASMS Meeting found that immediate free flap breast reconstruction for women with breast cancer is safe and psychologically beneficial.
The study, which followed 170 patients with locally advanced breast cancer, found that immediate reconstruction did not delay post-operative chemotherapy, prolong recovery or hinder the diagnosis of local cancer reccurrence.
"Losing a breast is traumatic," said ASPS Member James Watson, MD, and participating surgeon in the study. "As a board-certified plastic surgeon, I wanted to ensure that immediate breast reconstruction was safe for my patients and would make the healing process easier. The findings in this study will allow women to start healing sooner psychologically, knowing that their decision will not impede their physical progress against breast cancer."
The paper states that women participating in the study were pleased with their immediate reconstruction experience, indicating an immeasurable emotional benefit patients gain by having the reconstruction right away.
According to the findings, the majority of patients were either satisfied or very satisfied with their reconstruction and, if they had to, would have it done immediately after their mastectomy again. Also, the majority of women agreed they would recommend immediate reconstruction to a friend or colleague.
Through the study, Dr. Watson found that immediate free flap reconstruction - where the patient's own tissue is removed from the abdomen, buttocks or thigh regions and reattached in the breast using microsurgical techniques - resulted in similar complications and delays of post-operative chemotherapy to patients who delayed reconstruction. The most common postponement for patients was waiting for the wound to heal. However, the maximum delay was only three weeks, which did not have significant oncological impact on their post-operative therapy.
Also, while there were local recurrences of the cancer, physicians were able to diagnose the cancer's return quickly, resulting in no delay for additional treatment. Most local recurrences were located at the mastectomy scar or in the mastectomy flaps, which could be diagnosed by a physical exam and biopsy.
"An added benefit to reconstructing the breast immediately is that it's easier for the oncology surgeon to complete the mastectomy. Often, the breast cancer is so large or involves so much skin that the surgeon has to remove additional skin in the region, making it difficult to reserve enough tissue to close the wound," stated Dr. Watson. "With immediate reconstruction, the oncologic surgeon can eliminate more breast skin to ensure the cancer is removed and use the skin from the free flap procedure to close the wound."
According to ASPS 2001 statistics, more than 190,000 women were diagnosed with breast cancer and more than 80,000 women opted for breast reconstruction following a mastectomy.
Access to breast reconstruction following a mastectomy has increased due to the passage of the Women's Health and Cancer Rights Act 1998, proudly supported by ASPS, which mandated insurance coverage for breast reconstruction and the alteration of the opposite breast for symmetry for women who have undergone a mastectomy.
"With the finding that reconstruction right after mastectomy is safe, women can maximize their opportunity to not only heal physically but also psychologically right away," said Dr. Watson. "Before, women had to wrestle with their changed body image after losing a breast while physically recovering from their battle with cancer. Now, they don't have to delay the psychological healing process of beating breast cancer and celebrating that victory."
*****
Dr Chrysopoulo is board certified in Plastic and Reconstructive Surgery and specializes in breast reconstruction surgery after mastectomy for breast cancer. He and his partners perform hundreds of microsurgical breast reconstructions with perforator flaps each year including the DIEP flap procedure. PRMA Plastic Surgery, San Antonio, Texas. Toll Free: (800) 692-5565. Keep up to date with the latest breast reconstruction news by following Dr Chrysopoulo's Breast Reconstruction Blog.
******
Wednesday, August 29, 2007
The Hype Around DIEP Flap Breast Reconstruction And How To Find A DIEP Flap Surgeon
If you are a woman facing mastectomy you have a decision to make: do I want breast reconstruction? If the answer is “yes”, plastic surgery holds the key. Although reconstruction cannot replace the breast(s) you were born with or allow you to breastfeed, it can restore your natural silhouette and make you feel “whole” again following mastectomy.
Depending on your health, breast reconstruction can be performed immediately after your mastectomy surgery so you can wake up with new breasts already in place. While the cosmetic results with immediate reconstruction are generally superior, breast reconstruction can also be performed at a later time once the cancer treatment has been completed.
The DIEP flap breast procedure is today’s gold standard in breast reconstruction. Advances in breast reconstruction have made it possible to use excess skin and fat from the abdomen (rather like the tissue removed during a tummy tuck) to construct a new breast without the need for implants or the sacrifice of abdominal muscle. This procedure, known as the Deep Inferior Epigastric Perforator (DIEP) flap, is a sophisticated modification of an existing procedure known as the TRAM (Transverse Rectus Abdominus Myocutaneous) flap.
TRAM flap surgery is a common breast reconstruction technique that requires the rectus abdominus (sit-up) muscle to be sacrificed and relocated to the upper abdomen. Unfortunately, this technique can be associated with significant post-operative pain, prolonged recovery, loss of abdominal muscle strength (up to 20%), abdominal bulging (or “pooching”), and even abdominal hernia.
DIEP flap breast reconstruction is similar to TRAM flap surgery but spares the rectus abdominus muscle. SKIN AND FAT ONLY are removed from the abdomen, transplanted to the chest and connected using microsurgery to create the new breast. NO MUSCLE is sacrificed. As the sit-up muscle is left behind in its natural place many of the above complications are avoided and the patient essentially receives a tummy tuck at the same time as the breast reconstruction. There also tends to be far less pain following the DIEP procedure, and a quicker recovery time.
Knowing the significant advantages of the DIEP flap it is easy to understand the reason for all the hype, especially for active individuals who don’t want to sacrifice the strength of their abdomen. A breast that has been reconstructed with fat and skin will also look and feel more natural than an implant reconstruction and will last longer. Unlike an implant, the reconstructed breast also ages like a natural breast.
As with all types of breast reconstruction however, 2 or 3 procedures performed a few months apart are often required to complete the reconstruction process and to obtain the best cosmetic result. Unfortunately, due to the complexity of the DIEP procedure very few centers in the US perform DIEP flap surgery so many patients will have to travel for the procedure. The good news is that many of these DIEP flap centers will accommodate out-of-state and even international patients.
To learn if a breast center or plastic surgeon near you offers DIEP flap breast reconstruction, please check the following websites:
www.breastrecon.com and www.diepsisters.com
The lists on these websites seem fairly thorough but there are plastic surgeons out there who perform DIEP breast reconstruction that have not made the lists (for whatever reason). Having said that, currently there are only about 40 plastic surgeons in the US that routinely perform the DIEP flap procedure. Before choosing a plastic surgeon ensure that he/she is certified by the American Board of Plastic Surgery and has extensive experience with the DIEP flap procedure. Ask about the success rate of the procedure in their hands (most DIEP flap specialists boast a flap survival rate of at least 97%) and how many DIEP flaps they have performed.
Insurance companies are federally mandated to pay for the cost of breast reconstruction. Unfortunately, some patients will still face difficulties in gaining access to a DIEP flap surgeon and the procedure. Here again it pays to seek out plastic surgeons who specialize in the DIEP procedure as typically insurance specialists are available to help patients with insurance issues.
Learn more about the DIEP flap procedure and other breast reconstruction options here.
******
Dr Chrysopoulo is board certified in Plastic and Reconstructive Surgery and specializes in breast reconstruction surgery after mastectomy for breast cancer. He and his partners perform hundreds of microsurgical breast reconstructions with perforator flaps each year. PRMA Plastic Surgery, San Antonio, Texas. Toll Free: (800) 692-5565. Keep up to date with the latest breast reconstruction news by following Dr Chrysopoulo's Breast Reconstruction Blog.
*****
Depending on your health, breast reconstruction can be performed immediately after your mastectomy surgery so you can wake up with new breasts already in place. While the cosmetic results with immediate reconstruction are generally superior, breast reconstruction can also be performed at a later time once the cancer treatment has been completed.
The DIEP flap breast procedure is today’s gold standard in breast reconstruction. Advances in breast reconstruction have made it possible to use excess skin and fat from the abdomen (rather like the tissue removed during a tummy tuck) to construct a new breast without the need for implants or the sacrifice of abdominal muscle. This procedure, known as the Deep Inferior Epigastric Perforator (DIEP) flap, is a sophisticated modification of an existing procedure known as the TRAM (Transverse Rectus Abdominus Myocutaneous) flap.
TRAM flap surgery is a common breast reconstruction technique that requires the rectus abdominus (sit-up) muscle to be sacrificed and relocated to the upper abdomen. Unfortunately, this technique can be associated with significant post-operative pain, prolonged recovery, loss of abdominal muscle strength (up to 20%), abdominal bulging (or “pooching”), and even abdominal hernia.
DIEP flap breast reconstruction is similar to TRAM flap surgery but spares the rectus abdominus muscle. SKIN AND FAT ONLY are removed from the abdomen, transplanted to the chest and connected using microsurgery to create the new breast. NO MUSCLE is sacrificed. As the sit-up muscle is left behind in its natural place many of the above complications are avoided and the patient essentially receives a tummy tuck at the same time as the breast reconstruction. There also tends to be far less pain following the DIEP procedure, and a quicker recovery time.
Knowing the significant advantages of the DIEP flap it is easy to understand the reason for all the hype, especially for active individuals who don’t want to sacrifice the strength of their abdomen. A breast that has been reconstructed with fat and skin will also look and feel more natural than an implant reconstruction and will last longer. Unlike an implant, the reconstructed breast also ages like a natural breast.
As with all types of breast reconstruction however, 2 or 3 procedures performed a few months apart are often required to complete the reconstruction process and to obtain the best cosmetic result. Unfortunately, due to the complexity of the DIEP procedure very few centers in the US perform DIEP flap surgery so many patients will have to travel for the procedure. The good news is that many of these DIEP flap centers will accommodate out-of-state and even international patients.
To learn if a breast center or plastic surgeon near you offers DIEP flap breast reconstruction, please check the following websites:
www.breastrecon.com and www.diepsisters.com
The lists on these websites seem fairly thorough but there are plastic surgeons out there who perform DIEP breast reconstruction that have not made the lists (for whatever reason). Having said that, currently there are only about 40 plastic surgeons in the US that routinely perform the DIEP flap procedure. Before choosing a plastic surgeon ensure that he/she is certified by the American Board of Plastic Surgery and has extensive experience with the DIEP flap procedure. Ask about the success rate of the procedure in their hands (most DIEP flap specialists boast a flap survival rate of at least 97%) and how many DIEP flaps they have performed.
Insurance companies are federally mandated to pay for the cost of breast reconstruction. Unfortunately, some patients will still face difficulties in gaining access to a DIEP flap surgeon and the procedure. Here again it pays to seek out plastic surgeons who specialize in the DIEP procedure as typically insurance specialists are available to help patients with insurance issues.
Learn more about the DIEP flap procedure and other breast reconstruction options here.
******
Dr Chrysopoulo is board certified in Plastic and Reconstructive Surgery and specializes in breast reconstruction surgery after mastectomy for breast cancer. He and his partners perform hundreds of microsurgical breast reconstructions with perforator flaps each year. PRMA Plastic Surgery, San Antonio, Texas. Toll Free: (800) 692-5565. Keep up to date with the latest breast reconstruction news by following Dr Chrysopoulo's Breast Reconstruction Blog.
*****
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