30 June 15

Breast Reconstructions after a Mastectomy/Breast Cancer

Have you just had a Mastectomy or you know someone who has?

You don’t know whether a breast reconstruction is the best option for you? 

You DO have options

You can’t predict how you will react and feel once you have lost your breast so we really wanted you to get a well-rounded understanding of facts, statistics and real life stories.

Your surgeon may ask you if you want a breast reconstruction at the time of your mastectomy. There are things you need to know and be aware of before you make you decision.

You want to ensure you make the best decision for you and avoid feeling like you have to make a decision in haste.

The aim of the process is for you to get back to feeling like yourself as quickly as possible.

Breast Reconstructions after a Mastectomy:Breast Cancer

Some of the things you’ll want to know and think about are.

 

  • How important is reconstructing your breast to you?
  • Does having an external breast form sound like an option you can live with? What are my options for Breast Forms? What features and benefits fit in with my lifestyle?
  • Will having a breast reconstruction help you to feel more like yourself?
  • Are you OK with having more surgery? Are you OK with the need for any possible balancing surgeries/ procedures in the future?

 

There was a survey conducted by The Wollongong University in 2009 with women that have had a single Mastectomy, the findings were:

 

    1. 22.5% of women have a reconstruction after a Mastectomy.
    2. In terms of having a Bi-Lateral where both breasts are removed, 20% of women choose not to have a breast reconstruction.
    3. Radiation therapy can damage a reconstructed breast; sometimes a woman may not know whether she needs radiation therapy until after her mastectomy. This can make planning ahead for an immediate reconstruction difficult.

1 in 6 of Mastectomy’s were Bi-Laterals in 2010; this number is increasing due to Gene Testing.

If you have had a single Mastectomy and are thinking about having a reconstruction ask the Surgeon-

  • If the cancer returns to the original site, will you be able to detect it?
  • If one breast is natural and one is an implant what happens when you age?

 

Questions to ask your surgeon.

Before your consultations-

  • Do your research
  • See more then one Plastic Surgeon

Ask Questions like-

 

  1. What is the recommended cup size for my body shape?
  2. Ask for referrals from other women who have had a Mastectomy and those the surgeon has performed a previous reconstruction.
  3. Do you think a reconstruction is suitable for me?
  4. When would you advise me to have the reconstruction?
  5. Which type of reconstruction do you advise for me and why?
  6. What are the possible problems with this type of reconstruction?
  7. How long will I be in hospital and how long will it take me to recover at home?
  8. How much will it cost? Does Medicare cover me? Am I covered by my private health fund?
  9. What will the new breast look and feel like?
  10. Can I see photos of other women who have had this type of reconstruction?
  11. Can I still have a mammogram after having the reconstructed breast?
  12. What options do I have for Nipple reconstruction?

If there are answers you do not understand, feel comfortable to say ‘Can you explain that again?’ or ‘I am not sure what you mean by…’ Think about taking a support person with you. By taking a friend or family member they can help discuss the information given and even may help you remember what you might forget.

 

What experiences have other breast cancers survivors had with their reconstructions?

 

1. Why did you choose to have a breast reconstruction/ no breast reconstruction? 

Ana:I was diagnosed at 27, and the decisions about my treatment plan came quick. There was not a lot of time for research or to figure out what the best move would be or what those decisions would look like years down the road. My cancer was very aggressive, and I was under the knife less than two weeks after my diagnosis. My surgical options had to be decided almost immediately.

However, I did have time to speak with a great group of women before my final decision. I saw and discussed the result of many types of reconstructive surgeries, and my plastic surgeon was extremely informative, answering any and all of my questions. So, I felt like I made an informed decision. 

I knew I wanted to feel "normal" after breast cancer, and thought breast implant reconstruction could help with that. It does on some levels, but not on all. I look "normal" in my clothing from the outside, it isn't a question if I had breast cancer or not, but I am NOT "normal" under my clothing.” 
Susanne: I found it too confronting to my sense of being a woman to only have one breast. I wanted to feel ‘normal’.” 

Andrea: With my first breast cancer, I had a lumpectomy, which left a scar. The location of the scar caused me a few issues and I wore prosthesis. I didn’t quite feel comfortable with the breast and had investigated further reconstructive surgery.

When I was diagnosed with breast cancer the second time, I chose to have a breast reconstruction, as I couldn’t really see myself without one. It just didn’t feel right for me. So when I found out that I needed a mastectomy, I said, ‘can I have a reconstruction at the same time?’

 

 2. Did you have any problems that you didn’t expect? 

Ana: “Many things in your life change. All sensation is gone; there is no feeling at all in my chest area. Five years later, I still am dealing with a tremendous amount of scar tissue complications that require continuous physical therapy treatments. But, the biggest one I didn't expect was not fitting into my clothing or my bras. Maybe I was naive, but I just expected I would have breasts that would perform and act like the old ones. I didn't realize it was going to throw me for a loop when I was trying on bras that would no longer fit me. I didn't realize how foreign or different they would be.”

Susanne: “Yes, the surgery was long and complicated and I developed extreme lymphedema which meant the wound did not heal. I had a lot of draining and developed an infection. With all the fluid and infection, my implant became mobile and travelled to my back. I had to have further surgery to stitch it in place.  I was supposed to have a tattoo of a nipple and further procedures which I chose not to do.”

Andrea: “A breast reconstruction can be difficult depending on the type that you have, whether you’ve had radiation or not and how much body fat you have. I had a TRAM reconstruction from muscle and tissue from my tummy. There was an initial 1 hr surgery to prepare the veins in my stomach so that they could be moved easily. I found that simple surgery quite tricky to recover from. 

The second surgery was more major than I expected. It is mentally challenging to wake up with all the tubes and I was not really be able to move. But within a few days, I was feeling stronger and coping more each day.”

3. What was something that you found and/ or didn’t expect that you would tell other women going through this?

Anna:” I would recommend they find women, or ask their surgeon to refer them to women, who have had similar reconstructive surgeries. Today there are so many options, and those options are growing. See if you can meet women who are immediately out of surgery, and others who are maybe even a few years out. Talk to women who've had different types of surgeries. It will help give a well-rounded perspective on what you may be able to expect. Ask a lot of questions. Nothing is off-limits or "stupid." We are all willing to share our experiences and give perspective. We've been there, and we were scared, overwhelmed and confused, too.” 

Susanne: “I didn’t expect complications. However I accept that problems can always happen with surgery and I don’t blame the surgeons who were caring and concerned.

However what I didn’t expect was the freezing/coldness from my implant. I was so cold that I had to pile blankets over my left breast and it lasted for years until my body finally adapted to the implant and my temperature was under control.”

 

Andrea:” I am 100% happy with my new breast. I wasn’t sure that I would feel that way but I don’t really think about it anymore.

In terms of the surgery, ensure that you have support to help you for a couple of weeks after the surgery. I found it extremely difficult to even brush my hair or even hold my phone at the beginning. I couldn’t drive and I couldn’t really cook so all the help I received helped me to recover. It does take time!”

 

 4. What was important for you in the decision making process? 

Ana:” I recommend being your own advocate. Think about what you want, not necessarily what everyone else is doing or suggesting. For example, the nipple reconstruction and nipple tattooing was not for me. I felt like it was another procedure I didn't need, and I was already realizing having a nipple or something that was the illusion of a nipple wasn't going to make me feel any more whole than I already did. So, I took it upon myself and tattooed a tree of life around my chest. It is a beautiful piece that makes me feel strong and proud when I look in the mirror, and I don't immediately see the scars. But, that's me. You may feel differently, and that's okay. It's important to make your voice and your heart your compass throughout the process.”
Susanne:  “It was body image. It was not about vanity, but just not feeling like a woman, being different. It is hard enough to cope with what you look like and having only one breast made that too difficult.”

 

Andrea:I found the breast reconstruction options quite confusing. I took my Mum with me to help me to decide which surgical option worked for me. I asked my plastic surgeon to make a recommendation and to outline the positives and negatives of each option. I was very fortunate that my reconstruction was done through the public health system in New Zealand. My plastic surgeon was extremely helpful, warm and empathetic and that helped me.”

 

If you would like to read more on things like-

  • Sexuality and breast reconstruction
  • Pregnancy after a reconstruction
  • Financial issues
  • Making the decision

 

Go to http://www.cancervic.org.au/about-cancer/types-treatments-trials/breast_reconstruction_1/support_for_breast_reconstruction.html

 

Or you can telephone the Cancer Council Helpline on 13 11 20, Monday to Friday 8.30 am to 6 pm.

For more information on the new range of Trulife Breast Care, including external Breast Forms and Pocketed Bras, visit: www.bit.ly/trulife or Freecall Australia: 1800 809 635 or Toni Truda +61 411 859 009.

 

 

 Image source Rebel Society

 

 

 

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