New Approach to Breast Reconstruction May Reduce Pain and Weakness for Some
Breast Advocate App contributor, Dr. Hani Sbitany, discusses an alternative approach to traditional implant-based breast reconstruction in this NY Times article published yesterday.
For the past 30 years, the traditional method of implant-based breast reconstruction involved placing tissue expanders and implants underneath the chest wall muscles. It has been long believed that this muscle coverage offered lower rates of both infection and heavy scar tissue formation (capsular contracture) around the implant.
However, placement of a tissue expander or implant under the main chest muscle (pectoralis major) comes with certain risks to the patient. Specifically, the dissection and stretching of the muscle to fit the implant underneath, may increase the discomfort associated with the reconstruction, due to muscle spasm and tightness. Furthermore, in submuscular reconstruction, the pectoralis muscle heals to the overlying skin of the reconstructed breast, and in some patients moving forward, each contraction of the pectoralis muscle pulls the skin of the breast with it, causing breast animation or hyperanimation. This means that the breast temporarily becomes distorted and moves in an unnatural way when the patient uses her chest muscle.
Now some surgeons are placing the implants on top of the muscle in an effort to reduce complications like pain, weakness and “hyperanimation” deformities that can occur when the chest muscles are flexed. Results so far are extremely encouraging.
Shannen Doherty Undergoes “Stacked” DIEP Flap Breast Reconstruction Following Mastectomy
After being in remission from breast cancer for a year, Shannen Doherty underwent breast reconstruction surgery in May, reports People magazine.
She chose DIEP flap reconstruction. This procedure uses a patient’s own skin and fat from the lower tummy to recreate the breast following a mastectomy. Because of Doherty’s thin physique, she had to gain a little weight before surgery. The surgeon performed what is referred to as a “Stacked DIEP” which is a great option for thin patients. The stacked DIEP flap procedure uses tissue from both sides of the lower abdomen to reconstruct a single breast. The standard DIEP flap procedure uses one side of the abdomen to reconstruct each breast.
Usually, when women select DIEP flap surgery they are looking for the best long-term solution to breast reconstruction since tissue reconstructions age with them — the reconstructed breast(s) gain weight when they gain weight and lose weight when they lose weight. The tissue ages more naturally and, unlike implants, these reconstructions never need to be redone.
It is important for patients to know implants are not the only option for reconstructive surgery. Unfortunately, advanced procedures like the DIEP flap are not offered by all reconstructive plastic surgeons since extensive experience in microsurgery is required to perform these surgeries successfully. Patients must therefore do their homework in finding surgeons with the appropriate expertise.
“Know Your Girls” Campaign Aims to Help Black Women Take Charge of Their Breast Health
Black women in the U.S. are 40 percent more likely than white women to die from breast cancer. To address this disparity, the Susan G. Komen breast cancer organization has launched a campaign called “Know Your Girls.”
“The first step to closing this health disparity is to help black women take charge of their breast health by knowing their risk, knowing their bodies, getting screened, and talking with their doctors,” says the organization’s founder, Susan G. Komen. “By giving black women the tools to take charge of their breast health, we hope to help avoid unnecessary breast cancer deaths.”
Safely Skipping Chemo is an Option for Many Breast Cancer Patients
Breast cancer treatment is changing . . . and in a big way! A landmark study suggests that women with a common form of early-stage breast cancer can safely avoid chemotherapy without increasing the risk of recurrence.
The TAILORx study found that genetic testing on tumors could identify women who can safely skip chemotherapy. Rather than enduring the harsh side effects of chemo, such patients can take a drug (like tamoxifen) that safely blocks the hormone estrogen or stops the body from making it.
The results of this study could enable up to 70,000 US patients annually to avoid chemotherapy.
Large Number of Breast Cancer Survivors Not Getting Recommended Mammograms
Following a breast cancer diagnosis, women still need regular screening. However, a recent study shows many women are not following through with getting the recommended screenings they need.
The study followed over 27,000 women after their initial breast cancer surgery. The results showed one year after surgery, 13% of women had NOT had a mammogram. Over five years, only 50% of women had at least one mammogram each year.
The study also found that black women were less likely than white women to get an annual mammogram. “Lack of screening may contribute to higher death rates among black women, because recurrence of breast cancer is a major cause for poor outcomes in black women,” the researchers said.
