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Archives for February 2019

Ask the Doctor: Q&A

February 25, 2019 by

Q:
Hello,

I had a double mastectomy on June 5, 2018, for breast cancer. I finished chemotherapy on November 28th, 2018. I am interested in having the DIEP done and I read information about the ReSensation™ option and am very interested. I live in Aiken, S.C. and would love to get an appointment scheduled.

Thanks,
Erin

 

A:
Hi Erin,

I’m sorry you have had breast cancer, but we would be delighted to help you. We have done about 1,400 DIEP reconstructions over the last 15 years, with a 99% flap survival rate (plus about 300 other perforator flaps for breast reconstruction, mostly sGAPs and PAPs). We have been using ReSensation™ to improve the chances of restoring sensation since October 2017.

While there is not yet definitive published data proving that the nerve grafts help restore sensation, there are some promising early results. We have had some difficulty with certain insurance companies refusing to pay for the nerve grafts, but we would of course address that with them prior to your surgery. I would be delighted to see you in consultation at a time convenient for you. I typically see new patients on Tuesdays and Fridays, but I can often see patients on other days if it works better for you. Thanks for your inquiry, and have a great day!

Best,
Richard M. Kline Jr., M.D.

Dr. Kline trained in microsurgery with Dr. Robert Allen, who was pioneering the DIEP, SIEA, and GAP flaps.

Filed Under: Ask the Doctor

Breast Cancer and Younger Women

February 18, 2019 by

Most breast cancer is found in women who are over 50 years old, but lately it is becoming more common for younger women to be diagnosed with the disease. As a matter of fact, the Centers for Disease Control and Prevention (CDC) states that about 11 percent of all new cases of breast cancer in the United States are found in women who are younger than 45 years of age.

Young women who have been diagnosed are often confused and angry. Here are some stories from younger women (their last names have been withheld to protect their anonymity).

Jamie always felt like she had a higher risk of breast cancer, but never thought she’d be diagnosed at 38. “I thought if I ever got cancer it would be much later in life – when I was in my 60s or 70s,” she says.

Sarah was diagnosed two weeks shy of her 37th birthday. An otherwise healthy young woman, she was angry when the doctor told her she had breast cancer at such a young age.

Anna was diagnosed when she was only 34-years-old and, as a young mom to a 17-month-old daughter, she felt like her future family plans were quickly fading away.

Kristen has a three-year-old daughter, but her breast cancer diagnosis and chemo treatment wiped away her dreams of having another child. “This is the time when all my friends who had babies at the same time as me are having their second child,” she says.

According to the CDC, younger women are at a higher risk for breast cancer if they have close relatives who have also been diagnosed at a younger age, if they have the BRCA1 and BRCA2 gene, are of Ashkenazi Jewish heritage or have been treated with radiation therapy to the breast or chest in childhood or early adulthood. If they are diagnosed, the breast cancer is often found to be at a later stage and more aggressive.

Once diagnosed, younger women must make a variety of decisions concerning their treatment and their future. That includes decisions to have a mastectomy and reconstruction surgery, as well as deciding about childbirth. That is because some breast cancer chemo treatments might damage the ovaries, which can sometimes cause immediate or delayed infertility.

Dana says the hardest part of being a young breast cancer patient was going into the chemo room where the average age of the patients was about 60. “They look at me with such pity and said, ‘At least I’ve had a long life, saw my kids and grandkids grow up,’” she says. “But I will survive and will also see my kids grow up.”

The Center for Natural Breast Reconstruction believes in good health for everyone, regardless of their age. If you or someone you know is in need of breast reconstruction, contact them at NaturalBreastReconstruction.com or toll-free at (866) 374-2627.

Filed Under: Breast Cancer Awareness, Health and Wellness

Ask the Doctor: Q&A

February 11, 2019 by

Q:
I recently completed chemo for stage 3 IDC (invasive ductal carcinoma) in my left breast. I have chosen to have a bilateral mastectomy because I’m 44 and my oncologist recommended it. I’m scheduled for radiation after surgery. I was hoping to have immediate DIEP flap reconstruction but the plastic surgeon I spoke to today said he doesn’t recommend it until after radiation. I had originally consulted with an out-of-state plastic surgeon who said they perform the mastectomy and immediate reconstruction with skin flaps but they don’t recommend it with implants. My radiation oncologist even told me that statistically, women are more satisfied with immediate reconstruction. I’m very confused and if I can avoid having two surgeries, I would prefer that. Any advice would be greatly appreciated!

Thanks,
Angie

 

A:
Hi Angie,
I’m sorry you are going through this, but your question is an excellent one, and has been asked by many patients.
We try not to radiate natural tissue (flap) reconstructions, which includes DIEP flaps. As a rule, at best, the radiation will “shrivel up” the flap about 25% and make it firmer; at worst, it will shrivel it up to almost nothing. While some plastic surgeons don’t seem to mind these odds, we feel that in general, we do patients a disservice if we recommend radiating flaps. Additionally, if the flap is delayed until AFTER the radiation, it is usually the IDEAL method of reconstruction, and its success is not at all affected by the fact that the breast area has been radiated.
On the other hand, implant-based reconstructions, while faring more poorly when radiated than when not radiated, at least do not place priceless irreplaceable natural tissue at risk of loss. When we know or strongly suspect that a patient is to need post-operative radiation, we often recommend placing temporary tissue expanders in front of the muscle at the time of mastectomy(ies). After the radiation is complete, the expander is removed, and reconstruction with natural tissue (such as DIEP flap or sGAP flap) is performed. It is not absolutely necessary that a temporary tissue expander be placed, but it serves the dual purposes of providing a temporary breast mound, and often preventing excessive wrinkling and contraction of the remaining breast skin until reconstruction with your own tissue can be done.
I would be happy to chat with you by phone or see you in person to discuss your situation further, if you wish. We have performed more than 1400 DIEP flaps with a 99% success rate, and we are happy to share what we have learned in the process.

Thanks,
Dr. Richard M. Kline Jr., M.D.

Dr. Kline trained in microsurgery with Dr. Robert Allen, who was pioneering the DIEP, SIEA, and GAP flaps.

Filed Under: Ask the Doctor

Love Yourself

February 4, 2019 by

February is the month of love! As we celebrate Valentine’s Day and show those who are special to us how much we love them, why not do the same for yourself? As a breast cancer patient, you’ve been through diagnosis, surgery, treatment and possibly reconstruction and, of course, all the emotional ups and downs that have gone with it. This month, make sure you take some time to love and pamper yourself because you deserve it!

Love Your Bod

With breast cancer comes scars, hair loss, weight fluctuations and other changes to your body. Sometimes they are hard to accept, so the best way to start off a month about loving yourself is by loving your body and how it looks now. Yes, it’s changed, but it is hard at work fighting a disease, so be more confident about how beautiful you look. Maintain your beauty routine if it makes you feel good, accept compliments and wear clothes and hats that make you look and feel better.

Indulge

This month, millions of Americans will buy heart-shaped boxes of chocolates and indulge on rich desserts. It’s OK for you to indulge, too. If that occasional decadent dessert, piece of chocolate or dinner out makes you feel better, enjoy it!

Go Outside

In some parts of the country, it’s too chilly to take a walk, but if you can get outside for a bit, go for a walk. Many cancer patients stay inside during treatment and recovery and can suffer from winter blues. Going outside for some fresh hair and daylight can help your body to fight depression, sleep better and feel better. Even 15 minutes can make a difference.

Relax

Sometimes loving yourself means shutting out the world and enjoying your version of relaxation. Maybe it’s putting on your favorite music or romantic comedy movie. Perhaps it’s a long hot soak in a tub, reading a New York Times best-selling novel or filling in their crossword puzzle. Whatever it is, take time to do it. Your body and mind will appreciate it.

Pamper Yourself

Loving your bod, indulging and relaxation are all ways of pampering yourself, but if you need a few more ideas, how about a day at the spa? Buy that dress you always wanted or, depending on how you feel, take a quick weekend getaway from the hustle and bustle of tests and doctor appointments.

Breast reconstruction after mastectomy has been proven to help women feel better emotionally and physically. If you’ve recently gone through breast reconstructive surgery, loving yourself will help you to feel better about your breast cancer journey and how you look and feel. Also, talking to others who have gone through the process before you will also help.

Buddha once said, “You yourself, as much as anybody in the entire universe, deserve your love and affection.”

The Center for Natural Breast Reconstruction believes in good health for everyone, regardless of the season. If you or someone you know is in need of breast reconstruction, contact them at NaturalBreastReconstruction.com or toll-free at (866) 374-2627.

Filed Under: Health and Wellness