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Just as the technology behind chemotherapy and radiation therapy has improved in the last few decades – so have breast reconstruction options for female survivors of breast cancer.
“A majority of younger women choose reconstruction surgery,” said Dr. Toni Green-Cheatwood, breast surgeon for Penrose-St. Francis Health Services. Dr. Green-Cheatwood estimated that 80 percent of women under 60 opt for reconstruction, while about 50 percent of women over 60 choose to follow a mastectomy with breast reconstruction.
“It’s about taking control, even from a cosmetic perspective,” she said. “Some women have back pain from their breasts and might opt for a smaller size in reconstruction; it can improve quality of life.”
The breast surgeons at Penrose Cancer Center can offer survivors the latest in reconstruction methods, including nipple preservation and improved silicone implants. Penrose Cancer Center is part of the Centura Health Cancer Network, delivering advanced, integrated cancer care across Colorado and western Kansas.
“Reconstructing the nipple can be difficult, so we can do ‘nipple sparing’ on appropriate candidates. This is when we preserve the nipple from the original breast and incorporate it into the reconstruction,” Dr. Green-Cheatwood said. “The nipple at that point is just cosmetic, it’s not functional. But that can really make the difference for some women in how they feel about their breasts.”
In the 1980s, implants were filled with a silicone liquid that if ruptured, would leak and required maintenance or replacing. Now, implants are filled with a semi-solid silicone matrix – or gel – that maintain shape and form, even if compromised.
“There’s always room for improvement in the shape of implants, but we have come a long way,” she said. Surgeons can also substitute the Latissimus Dorsi muscle from the mid-back or fat from the stomach area to recreate the breast mound, rather than the more commonly used synthetic implants.
In the past 10 years, surgeons have also worked to preserve overlying breast skin tissue to perform immediate reconstruction versus delayed reconstruction, meaning the reconstruction process begins at the same time as the mastectomy or bilateral mastectomy and does not seem to significantly impede the healing process, though experts do not yet have long-term results for these procedures.
In the end, Dr. Green-Cheatwood said it really is up to the individual patient to choose which reconstruction path is best for her – emotionally and physically.
“There is so much attention paid to breasts in the media and movies, some women have a hard time with the idea of not having something on their chest, no matter the size,” she said. “Conversely, some women think it’s nice to not have to wear a bra or worry about them being in the way anymore. I’ve seen all types of women choose all kinds of reconstruction for themselves.”