This is another blog that will either be of great interest or zero interest to you. Women who need or choose to have a mastectomy (or bilateral mastectomies) must address the question of reconstruction. In our hospital, it is often presented by the surgeon in a single sentence: "Mrs. X, unfortunately you need to have a mastectomy, but we can do reconstruction at the same time." Intended to be reassuring, and no doubt it is for many, that sometimes forces women onto a train they might prefer to miss. The sentence should be something like this: "Mrs X, unfortunately you need to have a mastectomy, but there are a number of options. You can have the mastectomy with immediate reconstruction. You can choose not to have reconstruction. Or you can have the mastectomy now and consider the choice of reconstruction later."
This is a good review article from Breast Cancer Targets and Therapy about the current choices in reconstruction and some future directions. Per usual, I give you the abstract and a link:
Breast reconstruction: current and future options
Henry Paul Jr1 Tahira I Prendergast2 Bryson Nicholson2 Shenita White2 Wayne AI Frederick
Abstract: When initiated by the devastating diagnosis of cancer, post ablative breast restoration has at its core the goal of restoring anatomic normalcy. The concepts of body image, wholeness, and overall well-being have been introduced to explain the paramount psychological influence the breast has on both individuals and society as a whole. Hence, a growing subspecialty has been established to recreate or simulate the lost breast. At least one third of breast cancer victims consider breast reconstruction. Breast reconstruction post mastectomy may be offered at the time of mastectomy or delayed post mastectomy after adjuvant therapy. This may be utilizing autologous tissues or implants and each has risks and benefits, especially when considering adjuvant therapy. In addition, there has been a move away from a traditional mastectomy to less invasive, but still curative procedures, such as skin-sparing and nipple-sparing mastectomy. These procedures provide the breast envelope to facilitate reconstruction. This paper reviews the primary issues in breast reconstruction, as well as their psychologic, oncologic, and social impact.