Breast Reconstruction Options Not Always Clear

For many breast cancer patients undergoing mastectomies, reconstructive breast surgery is more about feeling whole again and less about restoring their appearance.

But, women seeking post-breast cancer reconstructive surgery many not be made fully aware of options available to them, reports the New York Times.

All plastic surgeons are not trained to perform the latest, complicated surgery while others may be financially based – some complex surgeries are less profitable for hospitals and so they have less of an incentive to offer them, doctors say.

While women “don’t choose their diagnosis, they choose reconstruction or not, and with the aid of a knowledgeable plastic surgeon they can choose what their options are,” said Dr. Linda G. Phillips, a plastic surgeon in Galveston, Texas. “They then have more power over their lives when they have the power to choose.”

“It is apparent that many reconstruction patients are not given the full scope of their options,” said Diana Zuckerman, president of NRC for Women and Families, a non-profit in Washington.

To help raise breast construction awareness, the American Society of Plastic Surgeons has adopted language that supports a woman’s freedom to choose reconstructive surgery as part of the society’s efforts to mark Breast Cancer Awareness Month every October.

It isn’t unusual for surgeons to omit informing patients about surgical procedures that they do not perform, said Dr. Michael McGuire, president-elect of the American Society of Plastic Surgeons.

Dr. Stephen Colen, chairman of plastic surgery at Hackensack University Medical Center in New Jersey, launched a program that assists women to meet with impartial physician assistants who go over the benefits versus the risks of available reconstruction methods.

“We wanted to put the decision in the hands of a medical person who has no personal or financial interest,” Colen said.

Breast reconstruction surgery is performed to rebuild the breast’s shape following a mastectomy. A reconstructed breast cannot give a woman her breast back; she will not have natural sensations. However, the surgery offers a result that looks like a breast.

During reconstruction, a surgeon forms a breast mound by using an implant or tissues extracted from the back, belly or buttocks of the patient. Implants are silicone sacs filed with silicone gel or salt water.

The type of reconstruction depends on age, body type and cancer treatment. Breast reconstruction surgery usually requires more than one surgery.

The National Cancer Institute estimates 184,000 new cases of breast cancer will be diagnosed in the U.S. in 2008.

In 2006, the latest figures available, 66,000 women in the U.S. had mastectomies, according to federal data. In 2007, about 57,000 women had reconstructive breast surgery, according to estimates from the plastic surgery society. #