Posts Tagged ‘breast reconstruction’

Some Mastectomy Patients May Be Ill-Informed About Breast Reconstruction

Thursday, March 17th, 2011

Are breast reconstruction patients making high-quality decisions about their procedures? This is the question posed by a recent article in the Journal of Plastic and Reconstructive Surgery, which has revealed that women treated with mastectomy were not well-informed about breast reconstruction. This is particularly serious since these patients were highly involved in making treatment decisions with their doctors.

The study was a cross-sectional survey of early-stage breast cancer survivors from four university medical centers. The survey included measures of knowledge about specific reconstruction facts, personal goals and concerns, and involvement in decision making.

Here are the survey questions, followed by the answer and the percentage of participants who answered correctly:

  1. Are women more satisfied with reconstruction at the time of the mastectomy or with delayed reconstruction? (They are equally satisfied, 33.3%)
  2. Are women more satisfied with the look and feel of breast implants or flaps? (Flaps, 15%)
  3. Does an implant use fat and tissue from other parts of the body to make a breast? (No, 13.1%)
  4. Does breast reconstruction with a flap usually require more than one surgery? (Yes, 28.6%)
  5. Which breast reconstruction surgery heals faster? (Implants, 57.1%)
  6. Roughly what percentage of women who have breast reconstruction will have a major complication, such as needing hospitalization or an unplanned procedure, within 2 years? Is it below 25, 25-50, 50-75, or more than 75? (25-50%, with only 3.6% knowing the correct answer!)
  7. How does breast reconstruction affect future screening for breast cancer? (Little to no effect, 35.7%)

A mastectomy is a life-changing experience, and reconstruction surgery offers many women a path to renewal and normality. Before taking that step, however, it’s always a good idea to ask lots of questions to make the best possible decision.

Women considering reconstruction surgery should ask their plastic surgeon about their options, and talk to others who have had similar experiences. They can also view resources from the American Society of Plastic Surgeons (ASPS) website, which has lots of information about breast reconstruction procedures.

Obese Patients Receive Equal Treatment in Breast Reconstruction

Monday, January 10th, 2011

A recent study presented at Plastic Surgery 2010 examined whether physician biases affected the treatment received by obese patients undergoing breast reconstruction.

In this video, Anita Kulkarni M.D. of the University of Michigan Department of Surgery, section of plastic surgery, explains the study, “Patterns of Use and Surgical Outcomes of Breast Reconstruction Among Obese Patients: Results from a Population Based Study.”

She explains that, for certain outcomes like “clothing fit and sexual attractiveness,” obese patients in the study were actually more satisfied with their treatment than normal weight patients. “ASPS (American Society of Plastic Surgeons) members are providing excellent care to this sometimes difficult patient population,” she says.

Study Evaluates Alloderm for Prevention of Breast Reconstruction Complications

Tuesday, December 21st, 2010

breast-recon-savannah-gaA recent study published in Plastic and Reconstructive Surgery examines the use of accellular cadaveric dermis (ACD) as an alternative to the total sub-muscular approach in breast reconstruction. During the breast reconstruction study, an Alloderm ACD – a bioengineered tissue substitute – created a “retaining envelope” for the breast implant, which was hypothesized to reduce the risk of capsular contracture.

Capsular contracture is a possible complication with some breast implant patients, occurring when scar tissue tightens around the implant. The cause of capsular contracture is unknown, but inflammatory reaction is thought to be a related problem. Doctors predicted that ACD could work by decreasing the typical inflammatory response that occurs around the breast implant.

Houston plastic surgeon Dr. Bob Basu, along with colleagues Dr. Mimi Leong and Dr. John Hicks, assessed the results of twenty breast cancer patients (average age 47) who underwent two-stage breast reconstruction.

During the two-stage breast reconstruction procedures, the ACD was attached in the breast crease as well as the pectoral muscle. The surgeons then created a space for the tissue expander, the lower part of which was covered by the ACD. After a few months, they removed the tissue expander and replaced it with a breast implant.

Between the procedure stages, Dr. Basu and his colleagues performed biopsies of the integrated ACD, along with histopathologic analysis. They found that, compared to the control group, the samples from the ACD showed significantly reduced levels of granulation tissue formation, among other positive differences.

The doctors concluded that ACD may impede capsule formation, thus possibly inhibiting capsular contracture. Although the findings of this study make a promising case for the continued use of bioengineered tissue in breast reconstruction, Dr. Basu stresses that it is only a snapshot of a process that takes place over several years, and further investigation is necessary to determine the effectiveness of ACD in eliminating capsular contracture.

Read the abstract in PRS Journal

New Law is Intended to Ensure Breast Reconstruction Patients are Informed

Monday, August 23rd, 2010

Breast reconstruction patients will now receive more information about the treatments that are available and how these treatments can be financed, thanks to a new law signed by NY Gov. David Paterson.

The law is intended to ensure that poor or disadvantaged women are informed about their various options in breast reconstruction.  Such options include health insurance coverage and a wide variety of surgical techniques that can reconstruct the breasts to restore a normal appearance.

An unfortunate reality is that many patients don’t undergo breast reconstruction because they’re not aware that the procedure has universal health insurance.  Doctors pushed for the new law so that a discussion of breast reconstruction options would be required, thus increasing the number of patients undergoing the surgery.

There seems to be a stark contrast in resources between breast reconstruction patients of different backgrounds.  Evidently, some are making decisions about treatment with a relative lack of information, while others are independently seeking out advanced microsurgical procedures.   According to a recent study in Plastic and Reconstructive Surgery, a growing number of breast cancer patients are using the Internet to find a reconstructive surgeon on their own, and many are choosing advanced microsurgical breast reconstruction procedures.

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