Breast Cancer - Reconstruction

One of the treatment options with breast cancer is a mastectomy, or removal of the breast. Depending on risk factors and genetic issues, some women have both breasts removed. Reconstruction is the rebuilding of one or both breasts. Reconstruction cannot completely replace a lost breast, but some women decide to have it done either at the time of the mastectomy, which is immediate reconstruction or at a later date, known as delayed reconstruction. It is a very personal decision that is usually based on how the patient feels about their body and breasts. Some women chose to have no reconstruction and use what is called a breast form.

One type of reconstruction makes use of synthetic implants. They can be either silicone filled or saline filled. Sometimes a temporary expander will be used if the implant is too large to insert under the skin and muscle of the chest wall. When an expander is used, it is injected every few weeks with a small amount of saline to gently stretch the skin and muscle to the size of the implant, at which time the actual implant will be inserted. This usually takes three to six months.

The other type of reconstruction makes use of the patient's own tissue. The tissue is transfered from another part of the body and consists of skin, muscle and fat - a myo-cutaneous flap, or just a flap. This is a fairly extensive procedure and not without a degree of risk. It is painful, both where the tissue is taken from and at the breast area, but it also provides the most natural looking results. The three different types of flap are the TRAM flap, which uses the abdominal muscles, the LAT flap, which uses the muscle from the upper back, and a Free Flap, which can be from the abdominal area or buttocks.

The TRAM flap involves cutting into the abs. The muscle, fat and skin are removed and pulled up to the breast area. The blood vessels are kept intact during the procedure. The flap is shaped into the form of the breast. Usually a good match to the other breast can be made and no implant is required in addition to the flap. The patient receives a tummy tuck as part of the deal, but runs the risk of developing a hernia from where the flap was removed.

A LAT flap follows the same procedure, using the latissimus dorsi muscle instead. The flap is pulled through a temporary tunnel, which is created under the skin from the back to the breast area. Because of the smaller size of the flap, an implant is usually added to make the breast larger.

The Free flap is the most technical of the three and involved the disruption of the blood supply to the flap during surgery. For this reason, you must have a surgeon that is skilled in microsurgery.

Another part of the reconstruction process involves nipple and areola recreation. In this procedure, a piece of skin is removed from another part of the body, the abdomen, leg or breast itself and shaped into a nipple. After it has healed, an areola is tattooed around the reconstructed nipple.

The reconstruction decision is a very personal one and since it involves surgery times of up to 4-5 hours under anesthesia, it's not one to be taken lightly.

Michael Russell Your Independent guide to Breast Cancer

October is National Breast Cancer Awareness Month: Take Control of Your Cancer Risk by Eating Super

Early detection, thanks to regular self-exams and mammograms, ups the chances of successfully treating and surviving breast cancer.

While finding the disease early is important, what if you could help prevent it from ever developing?

Research is mounting that women may be able to do just that – or, at least, greatly lower their risk of breast cancer -- by paying attention to what they eat and choosing foods that actually have breast cancer fighting properties.

“These are not exotic, medicinal tasting or hard-to-find items, but foods you can get at the grocery store,” says cancer expert and researcher Keith I. Block, MD, medical/scientific director of the Block Center for Integrative Cancer Care and Optimal Health in Evanston, Illinois. “The key is to incorporate them into your diet and eat them regularly.”

Dr. Block, Assistant Professor at the University of Illinois College of Medicine at Chicago and an Adjunct Assistant Professor of Pharmacognosy (the branch of pharmacology that deals with drugs in their natural state and with medicinal herbs and other plants) has researched data from numerous studies and come up with a list of “super foods” that may hold the key to preventing many breast cancers.

For example, “mangoes are rich in cancer-fighting phytochemicals and spinach contains a carotenoid called lutein that may inhibit breast cancer growth,” says Block. “Garlic and onions also contain a host of substances (including flavonols called quercetin and kaempferol and the antioxidant glutathione) that reduce breast cancer risk. Red peppers and tomatoes are loaded with lycopene, a phytochemical that appears to have tumor blocking properties. Other ‘super foods’ with potent cancer preventing properties include corn, tofu, brown basmati rice, whole wheat, red beans, lemon juice and olive oil. In fact, use olive oil instead of other fats for salad dressing and cooking. According to a study released earlier this year, oleic acid, which is found in olive oil, may help inactivate a cancer gene that is responsible for up to 30% of all breast cancers.”

Changing your diet to include foods that may substantially lower your risk of breast cancer is not only a smart choice – it can be a delicious one, according to Penny Block, Co-founder of the Block Center and author of the cook book, A Banquet of Health which features over 200 tantalizing recipes including many of the world's favorite traditional dishes, only with a healthy twist. “The ‘super foods’ can be incorporated into everything from entrees to dips and salsas and even desserts. How you prepare food can also help lower your cancer risk,” Penny adds.

Another reason to pay attention to what you eat comes from a study recently published in the International Journal of Cancer concluded that eating foods that have a high glycemic index may raise the risk of breast cancer among older women. “The glycemic index measures how fast and how high blood sugar rises after you eat foods containing carbohydrates. For example, white bread, sugar and potato chips are high glycemic foods that are converted almost immediately to a rapid spike in blood sugar,” Dr. Block explains. “Brown rice and whole wheat, on the other hand, have a lower glycemic index. They are digested more gradually, leading to a lower and more gentle change in blood sugar. These are the kinds of foods you want to incorporate into a healthy and cancer preventative lifestyle.”

According to the American Cancer Society (ACS), American women have a one in eight chance of developing breast cancer during their lifetime. ACS data show that more than 45,500 Americans, almost all women, died from the disease last year and about three million US women currently have breast cancer.

Betty Hoeffner has been writing articles for various media outlets for the past 30 years. She is currently producer of a patient safety film called Things You Should Know Before You Enter the Hospital and president of Hey U.G.L.Y., Inc. NFP, a 501C3 nonprofit organization that empowers teens with self-esteem building tools, to help them counter challenges such as eating disorders, bullying, violence, substance abuse and suicide. U.G.L.Y. is an acronym meaning Unique Gifted Lovable You.

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