Search Results for: history of breast cancer

Tram Reconstruction and Recurring Cancer in Breasts–How Should I Proceed?

This week, Dr. James Craigie of The Center for Natural Breast Reconstruction answers your questions.

Ask the DoctorQ: I had a mastectomy on my left breast with the tram–which partially failed–then Latisimis Dorsi surgery. I now have breast cancer in my right breast. What is the likelihood of decent symmetry and matching both breast shapes during this procedure?

A: I’m sorry to hear about your new diagnosis. In our practice, we have treated quite a few people referred to us with similar situations. We do not perform tram reconstruction but instead use the skin and fat of the lower tummy without taking the tummy muscle. If we have a patient that later develops a second breast cancer we would use skin and fat from either the upper buttock or the back of the upper thigh below the buttock. This can create a very good match for the tummy fat or a tram reconstruction. I would be glad to give you a more detailed answer with more specific information about your situation, let me know. I do think you most likely have good options without needing to give up any other important muscles. For more specific answers I will need to have my staff contact you for more details about your medical history.

Dr. James Craigie

Center for Natural Breast Reconstruction

Have a question about breast reconstruction or post-surgical care you’d like answered from our surgical team? Just ask us!

Can I Have Reconstruction After Recurrence of Cancer? Should I Go to My Local Surgeon or Elsewhere?

This week, Dr. Richard Kline and Dr. James Craigie of The Center for Natural Breast Reconstruction answer your questions.

Q: I have been diagnosed with a second primary breast cancer in the right breast. 13 years ago it was IDC now DCIS. What are my reconstruction options? 

A: I’m sorry you are having to deal with a recurrence. Glad to hear it is DCIS. I imagine you had radiation before and could have mastectomy with immediate reconstruction. If you like I will have my office contact you for a few more details.  I would be glad to set up a phone consult so you could get my opinion right away.

Dr. James Craigie

 

Q: I was referred by a coworker who was a patient. I’ve had a bilateral mastectomy, expanders and two sets of implants (taken out due to capsular contracture). My plastic surgeon said my body just isn’t taking to the implants and suggests I try DIEP flap reconstruction. My plastic surgeon does them, but my coworker said she recommends more experience. At this point I am torn. She suggested I contact you. I live in Florida and I am very comfortable with my surgeon, but understand the more you do, the better you are. I’ve also had a gastric bypass 10 years ago and I am scheduled for a hysterectomy (via DaVinci robot) Oct 2nd.

A: Thanks for your inquiry, and sorry for the trouble you’ve had.

Having said that, more surgeon experience, having two microsurgeons involved, and using a hospital with a dedicated flap team does potentially provide benefits, probably most so in terms of shorter operating times and increased flap survival rates. We have presently done about 1030 DIEP and GAP flaps, with a 98.4% survival rate, and we would be happy to see you at any time.

However, I would suggest that you consider discussing your concerns with your plastic surgeon, and if he still feels confident he can do it, I think I would give him the benefit of the doubt. Even if you ultimately decide to have your surgery elsewhere, it would be very helpful to have him on board with your decision.

Dr. Richard M. Kline, Jr.

Center for Natural Breast Reconstruction

Have a question about breast reconstruction you’d like answered from our surgical team? Just ask us!

Can You Obtain Perfect Symmetry in Breast Reconstruction?

This week, Dr. Richard Kline of The Center for Natural Breast Reconstruction answers your questions.

Q: I looked at your gallery  and I’m concerned about what I see as a mismatch in the photo examples. Is this not something you try to achieve?

A: Thank you for your wonderful question!

By “mismatch,” I’m assuming you mean the two breasts do not look the same when reconstruction is completed.

Firstly, we have many patients with very symmetrical breasts following reconstruction, and we could easily put only their pictures on our website, if we wished.

Thus far,  we have chosen to put less-perfect results on our website as well, believing it serves our potential patient population better, for the following several reasons.

In the real world, many patients will not be able to achieve a highly symmetrical result due to prior conditions, or will choose to not go through the multiple surgeries that will be required to get them as close to perfect symmetry as possible. If all patients came to us before their cancer was removed, we would coordinate their surgery with one of our highly experienced breast surgeons, they would nearly all receive nipple-sparing or at least skin-sparing mastectomies, and they would then have the greatest potential for good symmetry in the end.

In actuality, we see many patients from out of town who have already had non-skin-sparing mastectomies (often when nipple-sparing or skin-sparing mastectomies would have treated the cancer just as effectively). In this scenario, they have little potential to have their scar pattern converted to a more favorable one, and commonly need a lot of extra flap skin left in place in the breast. Occasionally a temporary tissue expander can be used to reduce the size of the skin paddle, but this does not always work, especially in radiated patients. If they chose to have a contralateral prophylactic mastectomy, they could then of course choose to have the same type of mastectomy on the other side (which would help symmetry), but many patients understandably do not want to do any more damage to their healthy breast than they have to.

Additionally, many patients are left with permanent changes in their skin from radiation, which can cause permanent color mismatches, as well as excessive tightness in the skin. This can make it very hard to match a radiated side to a non-radiated side, more so in some patients than others. The more times we can operate in this situation, the closer we get, but sometimes ideal symmetry remains elusive.

We want ladies who have already had aggressive mastectomies, who are left with significant radiation damage, or who don’t want to go through many, many surgeries in pursuit of ideal symmetry to know that there is still help for them, without implying to them that they will get a result that is probably not realistic. All busy reconstructive practices have these patients, but not all choose to put them on their websites. It may not be a good marketing decision for us, but we feel it is the most honest way to deal with our prospective patients.

We’d enjoy any feedback you’d care to give us on this topic, as we argue about it a good bit amongst ourselves.

 

Dr. Richard M. Kline, Jr.

Center for Natural Breast Reconstruction

Have a question about breast reconstruction you’d like answered from our surgical team? Just ask us!

Family History: Should I Consider A Preventive Mastectomy?

Ask the DoctorThis week, Dr. Richard Kline and Dr. James Craigie of The Center for Natural Breast Reconstruction answer your questions.

Q: I was diagnosed with stage 3 breast cancer about 3 years ago. I underwent all the usual treatments since then; however my oncologist has moved to another state, leaving me without one! I have not been able to get the reconstruction process completed.The last time I spoke with my oncologist, I was informed that it couldn’t be done. Do you think you can help?

A: Thanks for your inquiry!

Without knowing more details I can’t answer your question with certainty, but only rarely do we encounter a patient who can’t be reconstructed by any means. If you would like, we can have our nurse or PA call you to get more details.

 Dr. Richard M. Kline, Jr.

 

Q: My doctor recently told me that based on my family history–mom with a bilateral mastectomy, aunt (on mom’s side) with bilateral mastectomy, and another aunt (on mom’s side) with partial mastectomy–and combined with my PTEN mutation, thyroid issue, and other auto immune illnesses, that my chances of getting breast cancer in the next three years is 1 in 3. Should I seriously consider getting a preventive mastectomy?

A: A preventive mastectomy is the most effective way women can reduce their risk for breast cancer.

Close screenings with exams and x-rays or MRI, will only help with early detection and do not lower the chances of getting breast cancer. Women who are at high risk for breast cancer because of many different factors, family history or known genetic mutations do have preventive mastectomies to lower their chances. Before considering this big step you should review your risks with someone familiar with preventive mastectomies or a specialists in genetics.

It sounds like you have a doctor helping you through this decision. When it comes to proceeding further you should look for a team with a surgeon specializing in the breast removal and one specializing in rebuilding the breast at the same time as the mastectomy. Preventive mastectomies can preserve the breast skin and nipple, and are very different from most other types of mastectomy. Also the reconstructive procedures are specific for preventive mastectomies and have the chance to be the most natural results.

Our practice specializes in this type of breast reconstruction and we work with specialists who regularly perform nipple-sparing mastectomy. If you want more information we can contact you with a few more questions. Regarding my recommendation about when or if to do it I would say it is a very individualized decision to make, and the process is major surgery. You should know about all the risks and know what to expect regarding possible results.

We would be glad to review the details with you if you like. If so just let us know and I will have our PA or RN give you a call to discuss the details. I hope this helps.

Dr. James Craigie

Center for Natural Breast Reconstruction

Have a question about breast reconstruction you’d like answered from our surgical team? Just ask us!

Reducing Risk: Common Factors that Affect Your Risk of Breast Cancer

breast cancer risksThe American Cancer Society estimates that the lifetime risk of a woman developing breast cancer to be 13% in 2012—more than one in 8. Furthermore, 75% of all women with breast cancer today have no known risk factors, or anything that would potentially increase a person’s chance of developing cancer.

Though having a cancer risk factor, or even several of them, does not necessarily mean that a person will get cancer, it’s always a good idea to reduce risk as much as possible. Some of the factors associated with breast cancer—such as being a woman, age, and genetics—can’t be changed. Other factors, like maintaining a healthy weight, exercising, not smoking cigarettes, and eating nutritious food, are dictated by a person’s choices. By choosing the healthiest lifestyle options, you can make sure your breast cancer risk is as low as possible, and find empowerment in your good decisions.

Family History: Though you cannot change your heritage or genetics, being aware of your family’s history means you’re more inclined to protect yourself against diseases that are prevalent in your family tree. Research shows that women with close relatives who’ve been diagnosed with breast cancerhave a higher risk of developing the disease. If you’ve had one first-degree female relative (sister, mother, daughter) diagnosed with breast cancer, your risk is doubled. If two first-degree relatives have been diagnosed, your risk is 5 times higher than average. A family history of cancer of the ovaries, cervix, uterus, or colon increases your risk. Female descendants of Eastern and Central European Jews (Ashkenazi) also face increased risk. Caucasian women are at a slightly higher risk of developing breast cancer than are African-American, Asian, Hispanic, and Native American women. The exception to this is African-American women, who are more likely to have breast cancer than whites under the age of 40. If you inherited risk, you can minimize its development by making healthy lifestyle choices, such as not smoking, adhering to a nutritious diet, exercising, and abstaining from alcohol.

  • Alcohol Consumption: Compared to nondrinkers, women who consume one alcoholic drink a day have a very small increase in risk, and those who have 2 to 5 drinks daily have a 15% higher risk than women who do not drink. That risk goes up another 10% for each additional drink women have regularly each day. (Note: one drink equals 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of hard liquor). Research shows that alcohol of any sort can increase levels of estrogen and other hormones associated with hormone-receptor-positive breast cancer. Alcohol also may increase breast cancer risk by damaging DNA in cells. The bottom line is that regularly drinking alcohol can harm your health, even if you don’t binge drink or get drunk.
  • Smoking: Smoking causes a number of diseases and is linked to a higher risk of breast cancer in younger, premenopausal women. Research also demonstrates that there may be link between very heavy second-hand smoke exposure and breast cancer risk in postmenopausal women. Smoking also can increase complications from breast cancer treatment, including damage to the lungs from radiation therapy, difficulty healing after surgery and breast reconstruction, and an increased risk of blood clots when taking hormonal therapy medicines. To reduce your risk associated with smoking, the only solution is to quit smoking [http://breastreconstructionnetwork.com/stop-smoking-series-all-about-tobacco-quitlines/] immediately.
  • Diet and Nutrition: Diet is thought to be a main contributor for about 30% to 40% of all cancers. Though no food or diet can prevent you from getting breast cancer, some foods can boost your immune system and help keep your risk for breast cancer as low as possible. Getting the nutrients you need from a variety of fruits, vegetables, legumes, and whole grains can give your body the energy it needs to fight off infection and disease. Eating food grown without pesticides may also protect against unhealthy cell changes associated with pesticide use. Additionally, avoiding high-fat diets can also decrease breast cancer risk factors. Overweight women are thought to be at higher risk for breast cancer because the extra fat cells produce estrogen, which can cause extra breast cell growth and lead to the development of breast cancer.
  • Exercise: Research shows that exercising regularly at a moderate or intense level for 4 to 7 hours per week can lower the risk of breast cancer. Exercise consumes and controls blood sugar and limits insulin spikes in the bloodstream—an important preventative measure considering insulin is a hormone affects how breast cells grow and behave. People who exercise regularly tend to be healthier and are more likely to maintain a healthy weight. As we mentioned earlier, extra fat produces more estrogen. When breast cells are exposed to extra estrogen over time, the risk of developing breast cancer is higher Limiting fat in your diet is necessary for good health, and it is equally important to burn extra fat cells with exercise as an additional preventative measure.

What are some ways you combat the risk of developing breast cancer?

Breast Cancer Awareness Month: Where Will We Be?

Join The Center for Natural Breast Reconstruction throughout the month of October for National Breast Cancer Awareness Month! Our team will be attending all the collaborative events around Charleston that promote breast cancer awareness, share information on the disease, and promote treatment and reconstructive services.

Although many incredible strides have been made in breast cancer awareness and treatment, there remains much to be accomplished. Become part of the national dialogue on breast cancer, and help women around the world get informed about breast health when you join us for these special events:

  • BRA Day USA: Come celebrate our first BRA Day USA on Wednesday, October 17, 2012 aboard the dockside Carolina Belle on 10 Wharfside Street, Charleston, SC. BRA Day is an initiative designed to promote education, awareness, and access regarding post-mastectomy breast reconstruction. BRA Day USA is a collaborative effort between The Center for Natural Breast Reconstruction, plastic surgeons specializing in breast surgery, nurse navigators, medical device industry representatives, breast cancer patients and families, and breast cancer support groups. Join us for a little retail therapy, some great food, and outstanding prizes. Admission is free but limited to the venue capacity of 250. To secure your spot, be sure to RSVP to info@naturalbreastreconstruction.com.
  • Komen Race: The largest sequence of 5K run / walks in the world, the Susan G. Komen Race for the Cure®.  Series benefits education, research, and treatment programs for breast cancer. Three-fourths of the money raised by the Lowcountry Affiliate is invested into local projects, while the remainder supports national research programs. The 2012 Komen Lowcountry Race for the Cure® takes place Saturday, October 20, 2012 at the Family Circle Tennis Center in Daniels Island, SC. Enjoy the option of running or walking—by yourself or with a team—or you can sleep in for the Cure. Registration fees are $25 for individuals, $20 for team members, and $35 for sleepers. The registration fee includes the official Komen Race for the Cure® t-shirt and bib. If you’re a breast cancer survivor, let the organizers know, and you’ll receive a pink survivors t-shirt, hat, and bib! Check out www.KomenLowcountry.org to register and be part of an extraordinary cause!
  • Annual FORCE Conference: From October 18–20, 2012, we’ll be in Orlando, Florida for FORCE’s Against Hereditary Cancer Conference, a forum on hereditary breast and ovarian cancer. Join us as well as cancer survivors, high-risk individuals, those with a BRCA gene mutation or family history of cancer, and health care providers who treat high-risk patients. The conference will feature keynote speakers, exhibits, receptions, support groups, health and well-being assessments, and even a pool party! Come join the fun and learn more here: http://www.facingourrisk.org/events/annual_conference/index.php.

Which of these events will you attend this month? Let us know in the comments section and we’ll see you there!

One Breast Cancer Survivor’s New Take on Life: Laugh More and Love Harder

Today we are delighted to share this In her Words post featuring Regina McCray. Diagnosed at only 37 years old,  Regina shares her story with everyone she meets and is a ray of light for women diagnosed with breast cancer.

See below for our inspirational interview with Regina.

Tell us a little bit about your story and how you survived through breast cancer?

I was diagnosed with breast cancer on March 10, 2009 at the age of 37 years old. I had no family history, but because I work as a radiation therapist and see young women with cancer every day I started having mammograms at the age of 35.  My tumor was aggressive and was stage 2, grade 3, with one lymph node involved. I had a right breast mastectomy 3 weeks later and started chemo in April of 2009. I survived because of my faith in God, and the love of my parents and 11 siblings (I am the oldest child).  I also have a great support system of friends, co-workers and family.

You had to experience radiation as part of your treatment plan. What advice or information would you give to other women who need to experience radiation as part of their breast cancer treatment?

About 3 weeks after completing my last chemo treatment ( I did 6 round lasting from April to August) I started radiation, 33 treatments. Radiation only affects the area being treated so my skin got irritated like a bad sunburn, but my aloe vera plant worked wonders. Skin will be sensitive about 2 weeks into treatment and may start to get sore as treatment progresses, but the prescription creams given by the radiation oncologists usually work great. About 3 weeks after completion of treatment (usually 28-33  days Mon.-Fri) the skin will start to get back to normal.  For any woman needing radiation, it’s not as bad as most people think. You don’t feel the treatment, and it normally takes less than 10 minutes to receive treatment. Please don’t let the radiation horror stories scare you out of a treatment that is designed to kill microscopic cancer cells that may have been left behind. It is so worth the peace of mind!

You’ve been a great advocate for The Center for Natural Breast Reconstruction and a wonderful support source for your community. Tell us what you’ve been doing to support women who are experiencing breast cancer or know of someone who is?

After surgery, chemo, and radiation, I wanted to get my life, and body back so I joined support groups and started sharing my story with newly diagnosed women to help them get through the initial shock.  I speak to lots of my patients about my experience in order to let them know that they can get through it. I did a talk at my church to bring awareness to breast cancer, and I tell everyone that I come in contact with that if they know anyone that is battling this disease and need someone to talk to, they can call me anytime, day or night.

How has your life changed since being diagnosed with breast cancer?

Breast cancer has changed my life in so many ways, I never thought that something so painful, could make me a better person. I am grateful for the little things. I tell the people I love that I love them more often, and I don’t take for granted that I will have the chance of a tomorrow.  I live each day to the fullest, not caring nearly as much about pleasing others as I do about pleasing God and being happy.  I travel now and see places that I only dreamed about before, because now I know that tomorrow is not promised.  Even if I don’t make it to retirement,  God has given me today and I am enjoying Life! I laugh more and love harder.

What type of breast reconstruction did you have and would you recommend it to other women who might be contemplating natural breast reconstruction?

In May of 2010,  about 14 months after being diagnosed with breast cancer I went into the hospital for bilateral natural breast reconstruction along with a left mastectomy. Dr James Craigie (along with Dr Kline) performed the DIEP flap procedure  taking
fat and blood vessels from my tummy to make my beautiful new breasts. This procedure helped me feel whole again! I am so pleased with the results that I tell my patients, support group sisters, and anyone that is considering reconstruction that this is the way to go. My breasts feel like a part of my body, and I even have some feeling in them, not to mention they look great and I can wear a bathing suit and anything else, and look and feel great with my new girls and my flat tummy! I highly recommend the procedure and for anyone contemplating reconstruction please call Dr. Craigie’s office. He is in my opinion, the best Dr. on the planet. Skillful, patient, and his bedside manner is better than any other physician that you will ever meet. The staff is also awesome, courteous, patient and helpful.  I think the team from The Center for Natural Reconstruction was put here by God to give women like me a second chance, and they will always have a place in my heart!

Share this post with your friends on Twitter.

 

A Lesson Learned From Giuliana Rancic’s Breast Cancer Journey

guiliana-rancicE! News anchor Giuliana Rancic knows firsthand the importance of getting mammograms before turning 40.

At just 37 years of age, the TV personality was diagnosed with the early stages of breast cancer. She initially went through a double lumpectomy, before making the final decision to undergo a double mastectomy. All before the age of 40.

In an exclusive interview with Glamour magazine, Giuliana reveals her thoughts on the initial diagnosis: “I knew nothing about breast cancer before this happened to me, and I thought mastectomy meant stage three or four cancer. I didn’t have a big family history of it. I just never thought it would happen to me. I really didn’t.”

Breast cancer is a serious matter. It’s never too early to begin checking for lumps. According to the Susan G. Komen Foundation, 5% of all breast cancers occur in women under 40. This may not seem like a high number, but when there are over 226,000 women being diagnosed with breast cancer each year, 5% equates to roughly 11,000. That’s 11,000 women under 40 being diagnosed with breast cancer in the U.S. alone.

So what can you do to prevent a missed diagnosis as a young woman? Start checking early, and regularly. If you have a family history of breast cancer, consider starting your annual mammograms before you turn 40. Detecting breast cancer early is the best way to lower your risk and fully eradicate the disease.

It’s also never too early to perform self-exams. You should be familiar with the way your breasts normally look and feel. This will allow you to catch warning signs of breast cancer early.

When performing a self-exam, be on the lookout for the following:

  • Lump, hard knot, or thickening inside the breast or underarm area
  • Swelling, warmth, redness, or darkening of the breast
  • Change in the size or shape of the breast
  • Dimpling or puckering of the skin
  • Itchy, scaly sore or rash on the nipple
  • Pulling in of the nipple or other parts of the breast
  • Nipple discharge that starts suddenly
  • New pain in one spot that doesn’t go away

*All information above is provided by the Susan G. Komen Foundation

Educate your friends and daughters on the importance of detecting breast cancer early, and make sure they’re aware of the risks. Remember—breast cancer knows no age.

Follow Giuliana on Twitter today to stay up- to-date with on journey through breast cancer, motherhood and life!

 

Answering Your Breast Implant Questions

dr. richard klineThe question below is answered by Dr. Richard M. Kline, Jr., of The Center for Natural Breast Reconstruction

I had cancer in my left breast 15 yrs. ago, had the lump taken out, then developed a rather large cyst in the same breast. I had the cyst removed, which left me with only half a breast. I also had 8 weeks of radiation. I wanted a breast implant but the doctor said I couldn’t get one. Since it has been so long, could I now get one? I am 75 but still don’t feel good about my breast. I wear a breast form, but it’s not the same.

It is sometimes possible to reconstruct a lumpectomy defect with an implant, but your history of radiation makes success less likely. To some extent, the size of the implant you would require, and the amount of radiation injury you have sustained, influence the chances for success. Flap surgery, while significantly more involved, is ideal for use in radiated tissues, as it allows us to use healthy, non-radiated tissue to replace what is missing. Age, in and of itself, does not affect the success of either surgery, as long as you are generally healthy.

—Dr. Richard M. Kline, Jr.

Do you have a question about breast implants or natural breast reconstruction? Ask the doctor by emailing us at blog@naturalbreastreconstruction.com.

Celebrating National Hereditary Breast and Ovarian Cancer Week

Image to the left taken from the FacingOurRisk.org website.

In the United States, at least one million people carry genes, such as the BRCA or breast cancer gene, that put them at risk for cancer. In 2010, a Congressional resolution created National Hereditary Breast and Ovarian Cancer (HBOC) Week.

From September 25–October 2, 2011, HBOC Week raises awareness of hereditary cancer and recognizes those affected, including those with a family history of cancer, ovarian and breast cancer survivors, and previvors, those with a high risk of cancer who have not yet developed it.

Previvor Day is Wednesday, September 28, 2011, and a free teleconference with inspirational speaker and previvor Merit Gest will be held at noon EST. This event will focus on empowering previvors to understand the complex choices they face and make decisions about their health. To register, visit http://meritgest.com/national-previvor-day-september-28-2011.html.

HBOC Week falls in the week transitioning from Ovarian Cancer Awareness Month to Breast Cancer Awareness Month. During HBOC Week, Passing the Torch Ceremonies across the country pass a ceremonial flame from an ovarian cancer survivor to a breast cancer survivor to commemorate the transition.

The group FORCE (Facing Our Risk of Cancer Empowered) is a community dedicated to fighting hereditary breast and ovarian cancer, and it has chapters throughout the U.S. Events during HBOC Week are scheduled by local FORCE groups and can be found at http://www.facingourrisk.org/events/HBOCWeekEvents.php. This year, chapters will be sponsoring walk / runs, film screenings, conferences, discussions, and charity events.

FORCE’s website offers the latest information and research on HBOC, and features webinars, books, and movies, as well as support to hereditary cancer victims and their families. FORCE holds an annual conference and HBOC forum during the summer, and focuses on cancer advocacy, education, and peer support. Visitors to the site will find inspiring artwork and blogs, a tribute wall, and the latest news about HBOC.

For more information, or to find out how you can help, visit http://www.facingourrisk.org.