Breast cancer: deciding on reconstructive surgery

The different options of reconstructive surgery after breast cancer

Breast reconstruction is now performed most frequently after treatment is over, although physicians increasingly try to offer immediate reconstruction at the time of removal whenever possible. There are a number of options. “We take into account the morphotype, the wishes, the history and the patient’s previous treatment,” explains surgeon Fabien Reyal.

• Insertion of a breast implant is one of the most common solutions.
• Lipomodelling may also prove a promising alternative. It involves taking fat from other parts of the body, such as the abdomen, the hips or the inner thighs. This fat is then reinjected into the breast. The injected cells can help regenerate tissue damaged by treatment.
• Microsurgery involves removing excess fat or muscles that are not needed and “reconnecting” their vessels to those of the chest wall. The esthetic results are good.

Regardless of the method chosen, breast reconstruction often requires two or three surgeries over the course of several months.

In France only one in four women who undergo breast removal chooses reconstruction. Beyond the personal choice of accepting their new body as it is, among the reasons cited for not choosing breast reconstruction, 60% of patients claim a lack of information on the subject.

To make up for this, Dr Séverine Alran, a surgeon, and Lydie Wintz, a surgery executive, have created a working group called Info-Sein (Breast Info) at Institut Curie. Together, patients and caregivers have developed information tools, including a Q&A booklet provided to patients. All the medical, practical and esthetic issues are addressed. There is also an award-winning documentary on the subject, “Guérir le regard” (“Healing Our Perceptions”).