You have time to make the right decision.
One of the most devastating experiences a woman can face is the diagnoses of breast cancer. If you or someone close to you has been told you have breast cancer, it is important to learn about all the options available before making any decisions. Only in the most extreme cases will you be told to make an overnight decision. You have enough time to do some due diligence on your own behalf.
Mastectomies and reconstruction do not need to be done in a hospital.
The important thing to recognize is that mastectomies and reconstruction do not need to be done in a hospital. They are equally, if not more successful when accomplished in a private surgery center with a breast surgeon and plastic surgeon as a team for optimal results and a more personalized overall experience. The cancer doctor I partner with is one of the pioneers in nipple and areola sparing breast surgery. The advantage of this conservation is a more natural result through maintenance of the entire breast skin envelope as well as the natural nipple/areola complex. In addition, hospital infection rates even in best institutions are around 2%. This sounds low unless you are in that 2%. We have never had one.
Today, there are innovative breast-conserving procedures.
Today, there are breast-conserving procedures. Breast conserving surgeries remove the cancer, but not the breast itself. “Lumpectomy” or “partial mastectomies” are regional procedures where the suspicious mass and varying degrees of tissue around it are removed. A sentinel node biopsy is where one or more lymph nodes in the arm pit are remove and tested for cancer spread; this can determine if you may be a candidate for radiation or chemotherapy. Both of these cases can offer the benefit of immediate reconstruction.
Total, modified radical and radical mastectomies are not recommended as often as in years past.
Thankfully, treatment protocols have changed to reflect the latest research which supports the idea that less aggressive surgery does not influence survival or recurrence rates. Total, modified radical and radical mastectomies are surgeries that do not conserve the breast. However, simple mastectomies shell out the breast tissue leaving she entire breast skin and either the areola or nipple and areola. These options are determined by the location of the questionable mass as well as your surgeon’s personal philosophy. Reconstructive choices may include breast implants, tissue expanders or flap procedures. Your breast surgeon and oncologist will counsel you as to the timing, advantages and disadvantages of certain reconstructive techniques.
A small percentage of women are not candidates for in-house mastectomies.
This ideal situation is not available to all patients because certain more advanced breast cancer procedures are not safely accomplished in an office setting. Likewise, women who have had radiation therapy cannot have reconstruction after tissues are radiated, but reconstruction can be accomplished through fat grafting. Some insurance companies while willing to pay for procedures in hospitals are at this point unwilling to fund the same procedure in an office setting. This is being actively fought through the society of New York Office Based Surgical Facilities (NYOBS.)