breast cancer

Improvements in reconstruction one focus of DBCC breast cancer update

Betsy PriceCulture, Headlines, Health

breast cancer

Dr. Stephanie A. Caterson, right, looks at a silicon implant held by Dr. Dorothy Bird during their talk about breast reconstruction at the Delaware Breast Cancer Coalition’s annual treatment and services update.

The mechanics of breast reconstruction after cancer was one of the issues focused on Wednesday during Delaware Breast Cancer Coalition’s annual Breast Cancer Update.

The free event, held for the 26th time, is designed to update Delawareans about new treatments and services, as well as bring together patients, healthcare workers and others interested in the topic.

About 170 people signed up to participate in the online event, with some gathering at Goldey-Beacom College for an in-person watch party.

This year’s theme was Conquering the Unknown While Rising Above a Breast Cancer Diagnosis.

Other topics discussed at the update included hospice and palliative care, advances in mammograms, mental health and survivorship therapy.

The update began as a small scientific meeting to update physicians about the latest trends in breast cancer diagnosis and treatment. The coalition widened the audience to help empower the community.

DBCC Breast Cancer

The Delaware Breast Cancer Coaltion’s annual update drew a small crowd Wednesday for an in-person watch party at Goldey-Beacom College.

Breast reconstruction

ChristianaCare‘s Dr. Dr. Dorothy Bird, a reconstructive microsurgeon, and Dr. Stephanie A. Caterson, a reconstructive plastic surgeon, walked participants through various choices for breast reconstruction. They range from nothing to using silicone implants or tissue from a patient’s own body.

The surgeons said that they are often asked whether a patient must have a reconstruction, and it’s not required. But it is possible to have reconstruction years later, they said, and insurance often will pay for that.

Sometimes patients don’t want or aren’t ready for a reconstruction, or they may not be well enough to have one, Caterson said.

Sometimes, young women who are working and involved with the care of their children don’t want the longer recovery of reconstruction, she said.

When a patient doesn’t want reconstruction, surgeons can tailor the skin on the chest to create a flat closure that allows the patient to wear a prosthetic breast inside of their bra, Bird said. That can be done on one or both sides.

If the patient chooses to have it done for one breast, Byrd said they often will do a lift on the other breast so they more closely match.

A prosthetic often is ready about six weeks after surgery, she said.

The most common kinds of reconstruction involve having an implant or using the patient’s own fat.

Patients who decide to use an implant face a two-step procedure. The first step involved the doctor putting in a tissue expander, which can be filled with fluid to stretch the surrounding skin, and then putting in the implant itself.

The patient and her doctor will make decisions about what she wants based on the patient’s breast size and what their size goals are after surgery, as well as the type of mastectomy they plan to have.

It involves the doctor cutting tissue, often from the abdomen and containing skin, fat, blood vessels and sometimes muscle, and connecting the flap’s blood vessels to the blood vessels in the chest wall or armpit.

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Some patients who may have damaged blood vessels, maybe from various treatments or other issues, are not candidates for that because the surgeon can’t connect the blood vessels.

Patients who decide to use an implant face a two-step procedure. The first step involved the doctor putting in a tissue expander, which can be filled with fluid to stretch the surrounding skin, and then putting in the implant itself.

The patient and her doctor will make decisions about what she wants based on the patient’s breast size and what their size goals are after surgery, as well as the type of mastectomy they plan to have.

The procedure has been improved in the last two decades and is not as invasive as it once was. Pain management also has improved greatly, with doctors able to provide anti-inflammatory medicine before surgery and nerve blocks during it.

“It will be virtually numb in the chest area for several days after surgery,” Byrd said. “And during that time, you’re continuing to take the anti-inflammatory medication and the nerve medication,¬† which will help keep those nerves calm when the nerve numbing medicine starts to wear off.

“It’s almost as if your body didn’t even recognize that you’ve had a major surgery. So most of our patients go through these procedures with absolutely no narcotic use or no opioid use, which I think is a very impressive development that has happened throughout my career of breast reconstruction.”

 

 

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