Breast reconstruction: 4 things to know

For many breast cancer patients, breast reconstruction is an important part of cancer treatment. The goal of breast reconstruction surgery is to recreate part or all of the breast that has been removed during breast cancer treatment.

Reconstruction is known to benefit a patient’s body image and quality of life. But recent research shows that, in the U.S., fewer than 25% of breast cancer survivors understand the options for reconstruction, as well as the risks and benefits.

Here are four things to keep in mind when considering breast reconstruction surgery.   

Include your plastic surgeon early on

Talking with your plastic surgeon as early as possible in your treatment will help ensure you have the best possible breast reconstruction experience. It’s important to see someone who has extensive experience in breast reconstruction for breast cancer patients so that he or she fully understands the challenges of your unique situation.

Here at MD Anderson, the patient’s care team includes medical oncologists, radiation oncologists, breast surgeons and plastic surgeons so that your care is coordinated. This means we’re thinking about reconstructive surgery as we’re planning and going through the different parts of your treatment.

Radiation therapy doesn’t limit your options

Radiation therapy may affect timing or the type of reconstruction your plastic surgeon recommends, but reconstruction is almost always an option.

In general, if we think that you need radiation therapy, we recommend staging your breast reconstruction. This often involves a tissue expander placed at the mastectomy and then using your own tissue in a second surgery. If you have already had a mastectomy with radiation, your plastic surgeon will need to rebuild a breast using your own tissue (from your lower abdomen, buttock or back) with or without an implant.

Breast conservation surgery doesn’t mean you can’t have breast reconstruction

Breast conservation surgery (also called a lumpectomy) removes only the tumor and keeps as much of the healthy breast tissue as possible. It’s almost always followed by radiation therapy. This combination can affect the size and shape of the breast and may lead it to be mismatched with the unaffected breast. When this happens, a partial breast reconstruction (also known as an oncoplastic reconstruction) may be beneficial. We’re able to reshape your remaining breast tissue to improve its appearance after radiation. The plastic surgeon may also recommend a lift or reduction of the unaffected breast for symmetry, either at the time of your lumpectomy or after radiation is complete.

The timing of your reconstructive surgery matters

When it comes to scheduling your breast reconstruction, you and your care team may be able to choose whether to have the surgery before, during or after the rest of your breast cancer treatment. But the timing of your reconstruction can make a difference in the breast’s appearance. Some factors that may change your breast’s appearance include how much tissue is left after a mastectomy, scarring, or a change in skin color as a result of radiation. That’s why it’s important to meet with a plastic surgeon before having a mastectomy, if possible.

Some breast cancer patients can undergo breast reconstruction at the time of the mastectomy. For others, a staged approach is better, with reconstruction starting at the time of the mastectomy and being completed in a separate surgery after chemotherapy or radiation. But for some patients, it’s best to delay breast reconstruction altogether, either because of other medical factors or because the patient is not mentally ready.

The good news is that there’s no time limit on when you can get breast reconstruction. Although immediate reconstruction after a mastectomy may make surgery and your recovery a little tougher, it won’t delay your treatment after surgery. Some women undergo reconstructive surgery shortly after they’re done with treatment, while others wait months or even years so they have time to recover from treatment.

Whatever you prefer, remember to meet with your plastic surgeon early in your breast cancer treatment so you know all of your options and can pursue the reconstructive surgery timing and treatment that’s best for you.