Breast Cancer Q&A: Advances in Breast Reconstruction

Mothers and daughters for breast cancer awareness

Breast cancer awareness may be stronger than ever, thanks to the popular pink takeover of October. That’s a good thing. Heightened awareness about symptoms can improve rates of early detection, and awareness about risk factors can lead to health and lifestyle choices that may help women stay cancer free. But it doesn’t mean that people are necessarily aware of options available after breast cancer surgery, at least according to recent studies that show less than 50 percent of mastectomy patients undergo reconstructive surgery.

Breast reconstruction can help breast cancer survivors regain a sense of normalcy and positive body image after the figure-changing surgery. To explain more about it, Roper St. Francis affiliated plastic surgeon Dr. Ram Kalus answers a few questions.

Why should a mastectomy patient consider breast reconstruction?

A: Our reconstructive surgical techniques have advanced in recent years, and we now can make breasts look just like they did before mastectomy—sometimes, even better. A cancer diagnosis is often emotional and frightening, and anything we can do to help a patient have more confidence and feel better about themselves is part of what we offer as healers.

Who is a candidate for breast reconstruction?

A: Most patients are eligible for immediate reconstruction, when an implant is inserted during the same surgical procedure in which the breast is removed. With some aggressive cancers, when final pathology results are not available in time, we might recommend a delayed reconstruction. Either way, health insurers are legally required to cover reconstruction in the affected breast, as well as in the opposite breast in order to achieve symmetry.

What are the advancements in the surgery?

A: In the past, breast reconstruction would require two phases: first, we would insert a tissue expander to stretch the skin, then months later we would insert the implant. Today, we use a biologic substance called acelluar dermal matrix to form a pocket for the implant. This makes immediate reconstruction possible, including for patients who require radiation treatment (we used to avoid this fearing radiation would harden the implant). Now we have more and safer options for types of implants, which in general have a more natural feel, less risk of rupture and a smaller surgical incision.