Why Do So Few of Us Opt for Reconstruction?

Please read Joey's story on why she chose breast reconstruction.

Breast Reconstruction: Just Do It

http://www.healthcentral.com/breast-cancer/c/4564/8429/reconstructio/

Please do not hold up the American fetish  surrounding breasts as a reason to consider reconstruction.  Please do not assume women (or men) could not make their own choices.  Doctors are no longer the know all of the options. 

If a doc won't refer when asked that's a problem.

Hi mtn waters - I don't "buy in" to any pressure to "look good" as a reason for reconstruction. But I believe that most women want to look like we always have–with two breasts, not one or zero. We don't want to stand out from the crowd; we don't want to see our altered profile and be reminded of cancer. So reconstruction or a prosthesis can definitely help with that. I validate the feelings of any woman who doesn't choose anything beyond mastectomy. This is the MOST personal journey for all of us, and there should be no "shoulds" here - other than the fact that doctors SHOULD offer the reconstruction option to their patients, to take or leave as they see fit. - PJH

Hi PJ, I think that's a great response.  Thanks for clarifying.

Sarah

Reminds me that only ten years ago (I hope no longer) it was the doctor's decision to do a lumpectomy rather than a mastectomy without discussion with the patient!  Doctors made a determination regarding the anticipated cosmetic appearance of the breast after necessary surgery.  If the breast after lumpectomy would look not good in a bra or a bathing suit, the solution was a mastectomy!  Hard to believe!  And removal of the nipple was standard treatment, not a medical necessity in each case.

Thanks so much for sharing, and letting us know it's possible to get a reconstruction years after mastectomy. Your happiness with the result mirrors mine – I realize not everyone is so fortunate, but I'm THRILLED with my tram-flap reconstruction! - PJH

PJ,

 

I was glad to see your response to mtn waters, stating that you can validate any patient's feelings of not wanting reconstruction. I was just a little surprised you didn't mention it in your original article. My friend's wife just went through a mastectomy and wanted nothing to do with reconstruction. She simply did not want anything foreign put into her body. I can certainly understand this desire and as you mentioned, respect any wish that a patient might have regarding the issue. I think women should definitely not feel pressured by the media or anyone else.

Best Wishes,

Ricky

Hi Ricky: Thanks for taking the time to write. As I write over and over, ALL of this–every decision we make along the way–should be our own decision, made with help from friends, family, and health care pros, but coming ultimately from our own heart. We're the ones who have to live with ourselves - literally!
Just one clarification - there's nothing foreign in my body. I had body tissue reconstruction, so all that happened was I got a very welcome tummy tuck, with the "extra" removed going up to replace my lost breast. A true win-win! - PJH

PJ, thanks so much for that info. I was not aware of that option. I will pass along the info in case my friend's wife was unaware as well. The correct information is so important!

Ricky, be aware that implants (saline or silicone) are MUCH more common than autologous (body tissue) reconstructions. There may not be a plastic surgeon who does tissue reconstruction at the hospital your friend is being treated at, unfortunately... but worth asking, anyway. 

I absolutely believe every women should not only be told about reconstructive surgery but should be referred to one as soon as she finds out she has breast cancer prior to surgery. You can not make an informed decison about reconstruction if you only see a plastic surgeon after the fact. I had a lumpectomy in 2001 with radiation. My breast surgeon convinced me that if I had that surgery I would have less than a 4% chance of the cancer coming back. In 2003 it came back as stage 2 same breast & I had had a mamogram less than 6 months prior to finding this lump. I demanded a double mastectomy & immediate reconstructive surgery. Even though I had many reconstructive surgeries due to complications I believe that was due to my breast surgeon, not my plastic surgeon I would not change the decision I made to have the procedures done. Now it is 2008 & I am still cancer free. I live a very happy & full life. I only wanted to try to be back to normal as much as possible after the chemo hell. Going through the reconstruction process gave me something to look forward to.

 

I also wonder why more women don't have reconstruction done. The things they can do these days are nothing short of a miracle.

Vickie Hime

Paris, Texas   

While I can only speak for myself and from my own experience, I may understand why some women opt out of breast reconstruction.  I think at first, the fright and shock of cancer just makes the patient's immediate response one of "get as much of the cancer out of me as possible." Therefore, reconstruction at that stage isn't as high a priority as getting healthy and getting treated to eliminate as much cancer as possible.  Later, I think that more bilaterial mastectomy patients may decline reconstruction altogether because it isn't life saving surgery and they are at least symmetrical, so they may feel it would be better to just go on with life, rather than submit to more surgeries.  For unilateral patients, I would expect more of them will desire reconstruction in order to achieve some sort of symmetry.  However, delayed reconstructions are difficult for someone who has gone through the fear and lengths to treat the cancer.  Left on their own to find a surgeon that they will be comfortable with to perform the surgery is a daunting task.  There are plenty of plastic surgeons out there who make a pretty penny doing breast enlargements and lifts.  For the cancer survivor, being herded through routines like exams and videos and forms, in a setting that obviously caters to the cosmetic surgeries, is a very uncomfortable and cold experience.   It is actually almost insulting.   As if having/being treated for cancer wasn't bad/hard/scary enough.  I think we need more surgeons who specialize in reconstruction or who have compassion dealing with cancer/reconstruction patients.