Breast Reconstruction Awareness Day is October 16: Learn your rights.

When you’re diagnosed with breast cancer, you are given so much information to digest about your diagnosis and treatment it can, at times, be overwhelming. But it’s not over yet. What about the information you need to decide if you’re going to have breast reconstruction after a mastectomy or lumpectomy? Unfortunately, not every woman is given all of their options in order to make this very important decision.

To help change this, the American Society of Plastic Surgeons (ASPS) and The Plastic Surgery Foundation (The PSF) have designated October 16 as the eighth annual BRADay – Breast Reconstruction Awareness Day in hopes to build awareness around breast reconstruction options. According to http://www.breastreconusa.org, less than a quarter (23 percent) of women know all of the breast reconstruction options that are available to them after mastectomy.

“Thanks to the Women’s Health and Cancer Rights Act of 1998 (WHCRA), almost every woman is legally entitled to have breast reconstruction after mastectomy,” said Richard M Kline Jr., MD of The Center for Natural Breast Reconstruction. “Once you are aware of that, you should then understand what your all of your reconstruction options are, including implant based reconstruction, DIEP Flap, GAP Flap, and Profunda Artery

Perforator (PAP) Flap. Each procedure has its advantages and disadvantages so weigh them carefully.”

Once you are given your options for breast reconstruction, you need to decide which one is best for you and you will probably have a ton of questions. Make certain that you are consulting with a board certified plastic surgeon who is willing to answer all of them and share photos of post-operative results. The more informed you are with the answers you receive, the more comfortable you will be with your final decision.

All women who are candidates for breast reconstruction should receive treatment in a safe and timely manner.  Remember that this is your breast cancer journey and you should do what’s right for you. Keep in mind that only 19 percent of women understand that the timing of your treatment for breast cancer and the timing of the decision to undergo reconstruction greatly impacts their options and results.

For more information on Breast Reconstruction Awareness Day, visit breastreconusa.org. 

 

Previvors: Family History and Breast Cancer Risk

Abby recently found out that she has a family history of breast cancer — she has a cousin and a grandmother who have both been diagnosed at different stages. Abby is 37 years old and doesn’t have breast cancer, but the idea that she might have a higher risk of getting the disease because of her family history concerns her. She has decisions that she has to make about her health and what she needs to do to reduce her risks. Abby is known as a Previvor.

According to FORCE, Facing Our Risk of Cancer Empowered, a Previvor is an individual like Abby who may have a predisposition to cancer but who hasn’t actually had the disease. This includes people who carry a hereditary mutation, a family history of cancer, or some other predisposing factor.

In 2010, Congress passed the first-ever National Hereditary Breast and Ovarian Cancer (HBOC) Week and National Previvor Day to help raise awareness about hereditary cancer.

How do you know if you have a hereditary or higher risk for developing breast cancer?

 

Uncover your family history

 

To find out if you have a hereditary risk of being diagnosed with breast cancer  – start by taking a full health history of your own family. If any of your family members have battled breast cancer, find out how old they were when they were diagnosed, the type of breast cancer and the stage. And find out what age they were if they unfortunately succumbed to the disease. This family history should be as complete as possible and go back for as far as you can.

 

Your risk of getting breast cancer may increase if you have a first degree family member — mother, father, sister, or daughter — or multiple family members on either your mother’s or father’s side of the family who have had breast cancer.

According to the Centers for Disease Control, hereditary cancer syndromes are caused by mutations (changes) in certain genes passed from parents to children. In a hereditary cancer syndrome, certain patterns of cancer may be seen within families.

 

Genetic testing

 

The most publicly recognized breast cancer susceptibility genes are BRCA1 and BRCA2 but there are others. If you have a personal or family history of breast cancer, you can undergo BRCA genetic testing. A negative BRCA test result means that you do not have a detectable mutation in BRCA1 or BRCA2.  Some families have a BRCA mutation that is missed by this test, or another gene (s) that might explain the cancer in the family.  If you test negative for a BRCA mutation previously found in another family member, then you may have a true negative result.  A variant result means there is a variation in your genetic code, but it is unclear if it is the cause of the cancer in your family.  If you undergo genetic testing it is strongly recommended that you seek genetic counseling to understand the results and what the options are for your health.

 

Calculate your risk 

 

Studies have shown that your risk for breast cancer is due to a combination of factors. The main factors that influence your risk include being a woman and getting older. Most breast cancers are found in women who are 50 years old or older.

Some women will get breast cancer even without any other risk factors that they know of. Having a risk factor does not mean you will get the disease, and not all risk factors have the same effect. Most women have some risk factors, but most women do not get breast cancer. If you have breast cancer risk factors, talk with your doctor about ways you can lower your risk and about screening for breast cancer. 

Benefits of Autologous Reconstruction vs. Implant Reconstruction

When considering breast reconstruction, a woman is faced with a few options — she can

choose autologous reconstruction — which is the use of her own skin and tissue to

create a breast mound, implants, or go flat.

Recently, the recall of certain breast implants has made the news, as the FDA reported

their connection to 573 rare cases of anaplastic large cell lymphoma and 33 patient

deaths. As a result, the FDA asked Allergan to recall its BIOCELL textured breast

implants and tissue expanders and they obliged.

We are sure that this news is upsetting and leaves questions in the mind of patients

who wonder about implants and their safety, as well as the choice they should make for

their own breast reconstruction procedure.

At The Center for Natural Breast Reconstruction, we educate our patients on the

differences between all types of procedures and their risks, but our emphasis has

always been on autologous reconstruction. Here’s a little about each autologous

procedure that we do:

DIEP flap: This is the most popular type of perforator flap reconstruction due to its high

success rate and its ability to reconstruct the breast without the patient having to

sacrifice much needed abdominal muscles. In addition to reconstructing the breast, the

contour of the abdomen is often improved – much like a tummy tuck.

GAP flap: Similar to the DIEP, tissue is taken from the buttock area instead of the

stomach.

PAP flap: The Profunda Artery Perforator Flap (PAP) utilizes the tissue of the upper

thigh just below the buttock to reconstruct the breast following mastectomy.

So now that you know the difference between each procedure, why should you choose

autologous reconstruction over implants?

● Autologous reconstruction lasts a lifetime: Breast reconstruction using tissue

from someplace else on your body will last a lifetime. There is nothing synthetic

that can break or cause illness or other major issues. On the other hand,

implants will normally have to be replaced between 10 and 20 years.

● Breasts made by autologous reconstruction feels more natural: When your

breasts are reconstructed, you want them to feel just like your old breasts.

Implants do not always feel real, but since the tissue on your belly, buttocks, and

upper thighs is very similar to your breast tissue, it makes for a good, more

natural substitute.

Deciding what kind of procedure is best for you is a big decision. The best thing to do is

to gather all of your facts, talk with your doctor and your surgeon and weigh all of the

pros and cons before deciding on what’s right for you.

Woman to Woman

 

When you’re going through something big in your life, there isn’t anything more comforting than talking to someone who has been through it before.

For women who are having breast reconstruction surgery, a doctor is certainly available to answer many of your questions, but it’s also helpful to hear from another patient who has had the same surgery. What should you expect? How should you prepare at home? How will you feel when you wake up after surgery? What clothes are best to wear? When will you feel like yourself?

Meet Shirley. She’s a patient at The Center for Natural Breast Reconstruction who had a double mastectomy, followed by DIEP breast reconstruction surgery. She wanted to have a ‘girl-to-girl talk’ with other patients, so she wrote a 31-page booklet filled with raw, honest tips and advice that could help others. “No offense to the medical team that put together a technically comprehensive document, but boy did they leave out a lot of information that would have been helpful!” she wrote. “The kinds of things that, really, only a patient would know.”

Here is just a sampling of her tips and advice:

It’s a process, not a procedure:After the initial surgery, Shirley reminds patients that they will have one or two more minor procedures for final “sculpting.” “It’s important that you look at your reconstruction as a process, not one procedure and it’s done,” she writes. “Some healing is required between steps, and so there will be months between each step.”

Be vigilant at following instructions: Shirley made sure she followed her doctor’s instructions completely. That means that she ate a high-protein diet, made sure to exercise and took her vitamins. “I wanted to do whatever necessary to make sure everything went smoothly,” she writes. “Getting in shape prior to surgery will set you on a path to stay in shape, which will preserve your new body! Now that I have a flat tummy and perky “girls,” I’m more motivated than ever to stay fit.”

Go shopping before your surgery: It’s not just about retail therapy that will make you feel better. Shirley is advising patients to find specific clothing that will help with recuperation. “I would recommend that you get a very good idea of where your incision line will run and try to find some clothing that will be comfortable and not hit right on it for when you get home,” she writes. “And have large shirts at hand so that your drains will fit under. They need to button up the front, too, because it will be uncomfortable to raise your arms at first.”

Arrange help: “Another thing about showers — you have to dry off with a towel. So, here I was with limited arm movement juggling four drains and trying to dry all of my pieces and parts,” she writes. “I wasn’t supposed to be alone for showers the first couple of days. Dizziness and lightheadedness are common. My husband stayed with me and even helped me towel off, dress me and blow dry my hair. Naps usually followed showers.” If you don’t have a spouse, a trusted family member or friend should be available to help you.

Paint your toes:“Everyone will see your feet,” she writes. “I got so many comments on how pretty my toes looked. For some reason, that was comforting to me.”

Shirley also provides a day-to-day synopsis of her recovery, including her challenges such as sitting up after surgery and her accomplishments. Her booklet is helpful and inspiring to other patients who also may be struggling with finding the “light at the end of the tunnel.”

From one woman to another, Shirley gets you there.

The Center for Natural Breast Reconstruction would love to send Shirley’s book to anyone who like to receive it! Requests can be made via email, Facebook message, website chat, or phone at 843-849-8418. 

Why Keeping a Breast Cancer Journal Is Good for Recovery


For many young girls, it’s a rite of passage to keep a diary filled with secrets, hopes and dreams. It feels good to have a private place to write down those things that are too difficult to share with another living soul. Looking back at it later in life, it allows you to discover details that have long since been forgotten. Unfortunately most of us stopped writing in those diaries that were locked away when we hit our teen or adult years.

For women who find themselves on the emotional journey that is breast cancer, it might be time to start journaling again. Studies have shown there are mental and health benefits to journaling. After all, journaling has been shown to improve your mental health, reduce stress and make you feel better physically. It’s also just a great way to document your recovery.

Although not many studies exist on the effects of journaling, WebMD.com suggests that writing can improve sleep, help fight feelings of fatigue, and provide an outlet for positivity.
Before starting a journal, here are five ideas to guide you:

1. Rule #1: No Rules

The only rule to keeping a breast cancer journal is that there are no rules. Treat yourself to a new notebook or pretty journal or download one of the many journaling apps that are available. Write for a few minutes or several times a day. You can draw, write your thoughts in poetry or take pictures and write captions about what you see. Anything goes.

2. Start Anywhere

It doesn’t matter where you are in your breast cancer journey, you can start a journal today. You can work backward on the path you’ve already walked and write down as much as you can remember or write going forward only.

3. Be Prepared for the Emotions

One breast cancer patient had big aspirations of writing in a journal throughout her journey. Unfortunately, writing about her tests and treatment brought out too many emotions and she put the journaling aside. Journaling can be emotional, but it can be therapeutic too. If it gets to be too much, stop for the time being, but make a date to pick it back up again and perhaps write in smaller chunks or skip a few days in between. Find what works best for you.

4. Make a Caring Bridge Journal

There are online websites that allow you to journal and share it with family and friends who want to keep up with your journey but who may not be able to see you. “Anne-Marie” started a CaringBridge account to share her journey. She wasn’t posting every day, but often enough that when she goes back now and re-reads the entries, she remembers details about things that she started to forget.

5. Use Your Phone

Maybe you prefer to use your phone to journal, which is probably with you all the time. If so, try a journaling app, such as Dabble.me, Day One, or Five Minute Journal. Some charge a fee for the download but can provide prompts to remind you to write.
Whatever you do, and however you do it, make sure it works for you. That’s really the ultimate test of any effort to deal with your breast cancer journey.

Breast Cancer and Younger Women

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.

Seeing Friends and Family for the First Time Since Surgery

breast surgery visitorsThere is nothing like a support system to help you get through cancer diagnosis and
treatment. After you have surgery, your family members and friends will probably want
to stop by and visit. They may also want to cook for you, clean your home or just keep
you company as you recuperate.
While seeing friends and family can be a positive part of your recuperation, it can also
be overwhelming. You might not feel up to having company or you might feel self-
conscious about how you look. Here are some tips on how you should handle seeing
friends and family for the first time since surgery:
1. Talk About it Ahead of Time
If friends and family know when you are having surgery and want updates, use that time
to tell them what you expect about having visitors. For example, you—or the person
updating everyone for you—can say, “Mary is out of surgery and recuperating. If you’d
like to stop by and visit, please text or call us ahead of time so Mary can pick a time
when she’ll be up to enjoying your visit.”
2. Limit Time
Once you know when someone is going to stop by, it’s okay to limit how long they
spend with you. Visits can be fun, but they can be tiring. Let your friend or family
member know how much time you have to spend with them before you have to lay
down, change a dressing, etc. This is especially important for those who just drop by
without calling ahead of time. Feel free to say something like, “Thanks so much for
stopping by to see me. We can chat for a bit and then I’m going to lay down for a nap.”
3. Keep the Sick Away
You just had surgery and should be doing what you can to avoid getting sick. Let your
guests know that if they are germy or feeling under the weather in any capacity, they
should change their visit to another time. If they show up sick, it’s okay to tell them
you’re not feeling up to their visit and plan it for another time. For example, you can say,
“I’m excited to see you now that surgery is over, but it sounds like you’re getting a cold.
Can we reschedule your visit until you’re feeling better so I don’t catch it?”
4. Say No When You Need To
It’s okay to say no if you’re not up to having visitors on any particular day or only want
certain family members or friends to visit. This is your surgery recuperation and,
honestly, you have the right to handle it however you want. Simply say, “Thank you so
much for caring enough to visit, but I’m really not feeling up to guests right now. Can we
get together at another time?”
5. Don’t Let Feeling Self-conscious Get in the Way of Enjoying Visitors
Some women are self-conscious about having visitors, especially after surgery. While it
is normal to feel this way for a little while, think about who is visiting you and whether
they are worried more about how you look or how you feel. In most cases, your friend or
relative is there to see you and do what they can to help. They probably don’t care
about how you look, so it’s best to remind yourself why they are really there.
To learn more about natural breast reconstruction and find out if it might be the right
choice for you, contact The Center for Natural Breast Reconstruction at
NaturalBreastReconstruction.com or toll-free at 866-374-2627.

Opening up the Conversation on Family Cancer History

natural breast reconstructionAt the doctor’s office, you are given pages upon pages of paperwork to fill out about
insurance information, medications and past illnesses and surgeries. When you get to
the family history page it can be a bit overwhelming or you might even draw a complete
blank. Did your Aunt Mabel have breast cancer? You vaguely remember your father
telling you something about your second cousin’s diagnosis, but you can’t remember,
and now some family members aren’t talking, so the facts are elusive.
It’s important to open up the conversation on family medical history with your family
regardless of how difficult it may be. Why? Whether Aunt Mabel or your second cousin
had breast cancer is important to determining your own risk and your children’s risks.
With this information, you can make decisions about your own health, breast cancer
prevention and potential treatment, if you are diagnosed.

Unfortunately, starting a conversation with family about medical history, and especially
one about cancer, can often be difficult. While some family members may open up,
others may consider this private information, or they might get upset talking about
cancer. Others might not even know their own history.
So how do you find out what you need to know?
1. Make a List
Your medical history should include information from at least three generations of family
members — grandparents, parents, uncles, aunts, siblings, cousins, children, nieces,
nephews and grandchildren. Make a list of who you need to approach.
2. Explain What You’re Doing
Contact each family member – whether in writing, by email or by phone – and explain
that you are trying to obtain family medical history. If they are still reluctant to talk about
everything, try to ask specific questions about breast cancer. Some information is better
than none.
3. Ask Pertinent Questions
You should have a list of questions that you need answered. A complete family medical
history includes the age of the relative and any diagnosis or, if you are asking about a
deceased relative, the age and cause of death.
4. Keep it Confidential
Assure your relatives that the information you are compiling will be kept confidential —
and then keep it confidential.
5. Use Additional Resources
If your relatives are deceased or difficult to talk to, there may be other resources you
can use, such as public records – marriage licenses or death certificates.

Once you have all the information compiled, make sure you give a copy to your doctors
and update it regularly. They are bound by law to keep the information confidential.
To learn more about natural breast reconstruction and find out if it might be the right
choice for you, contact The Center for Natural Breast Reconstruction at
NaturalBreastReconstruction.com or toll-free at 866-374-2627.

I Tested BRCA Positive, Now What? 7 Things You Should Know

brca positive

If you have a family history of breast cancer and want to know if you’re at risk of getting it, too, a genetic test might provide the answers. A simple BRCA blood test can determine if there are changes in your genes, known as BRCA1 and BRCA2, which show you are at a higher risk of getting breast cancer. But what happens if your test results come back positive?

  1. A Positive Test Does Not Mean You Have Cancer: First, understand that a positive BRCA test result does not mean you already have breast cancer. Not everyone who is “BRCA positive” will get breast cancer down the road. There are many other factors that determine your ultimate breast cancer risk, including alcohol consumption, body weight, breast density, physical activity levels, age, and reproductive history, and this test result is just one. It is normal to worry about any positive test result, so the best thing to do is to inform yourself about what a positive BRCA test result means and what the next steps are if you test positive.
  2. A Positive Test Indicates You May Be at Risk: Statistics show a BRCA1 or BRCA2 gene mutation diagnosis means you have a 45 to 65 percent chance of getting with breast cancer by the time you turn 70. Remember, this doesn’t mean you will get cancer. It means you have a higher chance than someone else.
  3. A Positive Test May Alter Your Treatment: If you already have breast cancer, knowing you have a BRCA mutation may change your course of treatment as many breast cancers in women that are BRCA positive result in more aggressive tumors. Armed with this information, you should talk to your doctor about your current cancer treatment plan and determine what, if any, changes, should be made.
  4. You May Need Further Screening: If you have not been diagnosed, a BRCA positive test result should prompt you to create a screening plan with your doctor. You will probably have more breast screenings including mammograms, ultrasounds, and MRIs, starting at a younger age.
  5. Better Overall Health Improves Your Odds: Whether your test was positive or negative, taking steps to improve your health will reduce your risk of cancer. Eating right, not smoking, and avoiding the sun and other things that cause cancer help to improve your odds.
  6. You May Opt for Preventative Surgery: Depending on the genetic test results, your own health history and your current health, some women who are BRCA positive have undergone a preventative double mastectomy, which is the surgical removal of both breasts. It’s important to note that this reduces, but does not eliminate, your risk of developing breast cancer.
  7. You Need to Alert Your Family: Getting a positive BRCA test result naturally leads to concern about the breast cancer risk for children and other family members. Notify them of your positive results and talk to the genetic counselor about getting other family members tested.

To learn more about natural breast reconstruction and find out if it might be the right choice for you, contact The Center for Natural Breast Reconstruction at NaturalBreastReconstruction.com or toll-free at 866-374-2627.

The Many Choices in Breast Reconstruction Surgery

natural breast reconstruction

One aspect of a breast cancer diagnosis that requires careful consideration is choosing your reconstruction plan. Decisions about breast reconstruction can be emotional and confusing. Fortunately, you have several options from which to choose, but it’s important to know all the facts about each before you make a final decision that’s right for your body and your desired outcome.

If you choose to undergo breast reconstruction, you have the option to either have your breasts made from implants – saline or silicone – or from natural tissue flaps, which means they are made using your own skin, fat and muscle. There are pros and cons to each of these procedures.

Tissue Flap Reconstruction

Most women want to match the look and feel of their natural breasts, and there is a greater chance of successfully creating natural looking breasts by using tissue flap reconstruction. Using flaps to reconstruct your breasts will actually make them look and feel more natural compared to using silicone or saline implants. This is especially important as you age and your natural breast changes shape.

There are several types of flap procedures:

DIEP Flap: The most commonly used, DIEP flap procedure provides breast reconstruction and a tummy tuck all in one. That’s because this procedure uses your abdominal skin and tissue, but not your abdominal muscles.

PAP Flap: This flap procedure utilizes the tissues of your upper thigh to reconstruct the breast following your mastectomy.

GAP Flap: The tissue is taken from your buttock area, while the skin, fat and tiny blood vessels are removed through an incision that is hidden under your panty line.

SIEA Flap: This flap procedure is an option for the minority of women whose abdominal blood supply comes from the Superficial Inferior Epigastric Artery, which runs just below the surface of the skin.

Keep in mind that flap reconstructive surgery is a longer, more invasive procedure than having breast implant surgery. The good news is that flap reconstruction surgery hides the scars well from where your donor tissue was taken. It is also a procedure that does not need to be repeated in your lifetime, whereas silicone or saline implants may need to be replaced down the road.

Implant Reconstruction

When it comes to implant reconstructive surgery, you can choose to have the surgery at the same time as your mastectomy or at a later time. You can also choose saline or silicone implants. Saline are filled with a salt water solution. Saline implants start out deflated and are filled during surgery to the desired size. Silicone implants are pre-filled with a silicone gel.

Implant reconstructive surgery is less invasive than any of the flap surgical procedures, however they don’t provide as natural of a look as tissue flap reconstruction options.

There are other factors to consider when choosing a reconstruction option, including your current health status and whether or not you still need additional cancer treatment, such as radiation. Radiation can cause additional problems such as scarring that can cause delays in your surgery.

Discuss all of these options and their pros and cons with your surgeon to decide what’s right for you.

To learn more about natural breast reconstruction and find out if it might be the right choice for you, contact The Center for Natural Breast Reconstruction at NaturalBreastReconstruction.com or toll-free at 866-374-2627.