This week, Richard M. Kline, Jr., MD, of The Center for Natural Breast Reconstruction answers your question about breast reconstruction.
Question: My dear friend has recently been diagnosed with stage 1 breast cancer – estrogen driven. Cells were found in the ducts but negative in lymph flow. She has been scheduled for a mastectomy and she has decided to have both removed. She has been informed that she will need to have a hysterectomy soon after. I am an RN having worked in-house bedside with patients for 25 years. She is to be scheduled for surgery later this week and has been told reconstructive surgery for both breasts will be done as the surgery is completed. Is this commonly done? The patients I worked with generally had the reconstruction after chemo and radiation. What is your professional insight? She is terribly afraid and she has 11 and 8 yr old sons.
Answer: Yes, it is very common to have reconstruction done at the same time as the mastectomy. While there may be a slight increase in the complication rate doing it this way, most people feel that the advantages of doing them together outweigh any potential disadvantages. The one time that we would NEVER do immediate reconstruction is if the patient wanted natural tissue reconstruction, but we thought there was some chance that she would be radiated, as we NEVER want to radiate the transferred tissue. I do not wish to speak for your friend’s oncologists, but the two most frequent reasons for receiving radiation are 1) one or more positive lymph nodes, or 2) a tumor greater than 5 cm in largest dimension. Even if we know that radiation is to be received postoperatively, however, there is no problem reconstructing with implants or tissue expanders at the same time as mastectomies, and there may, in fact, be some potential advantages, primarily in terms of the quality of the final result.
I certainly understand your concern and your friend’s concern, but there is every reason to think that she will do well. If I can be of any assistance by talking to her or anyone else, please let me know, I would be happy to do so.
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