Summary: Recovery from a breast cancer diagnosis is an inherently traumatic and chaotic time, so it’s no surprise that decisions around breast reconstruction can be particularly challenging. There are many options—and options don’t necessarily equate to an easy choice. Reconstructive surgeons attempt to give patients nationwide, from Los Angeles to Ridgewood breast reconstruction options that fit their bodies and fit their lives. Sometimes it can be a difficult tightrope to walk, but when done well, a balanced approach—and an autologous breast reconstruction option—often lead to great patient satisfaction.
Breast Reconstruction Decisions Dilemma
Breast reconstruction can be a particularly troubling time. Often, the initial stages of breast reconstruction are performed concurrently with the initial stages of breast cancer treatment or diagnosis—for example, during mastectomy. Whether the mastectomy is preventative or a part of a broader treatment, it can be a traumatic experience—and certainly not a pleasant one. Incorporating breast reconstruction into the process can be a double-edged sword. On the one hand, the more incorporated breast reconstruction procedures are into the overall recovery and treatment process, the more successful they tend to be. Additionally, starting the reconstruction process so early imbues the entire treatment with a sense of hope—that a normal life is still an eventuality, that life will continue, and so on.
It’s not surprising, then, that reconstructive plastic surgeons are always looking for a way to make the process easier. Not terribly long ago, part of that mission to make the entire process easier involved the development of a study—specifically, a Breast-Q questionnaire, which sought to establish the most effective means of maintaining the highest satisfaction possible with this type of procedure. Essentially, the developers of the Breast-Q were looking for a qualitative way to measure satisfaction after breast reconstruction. Now that some of the data is in, researchers have been able to draw some conclusions about the best course of action in breast reconstruction cases.
Respecting the Decisions of Breast Reconstruction Patients
However, before we discuss those conclusions, it’s incumbent on us to mention that, of course, every woman and every case is different. While the study reports on some broad trends, it’s important to keep in mind that every woman is going to have different goals and desires, and that these goals and desires should be communicated to the surgical team and should be honored by that team. Typically, that is what happens—but difficulties arise when, due to the inherent chaos and trauma of the situation, patients have difficulty articulating precisely what it is that they want.
According to some of the results of the Breast-Q survey, autologous breast reconstruction options generally provided for the highest quality of life and satisfaction after the procedure. Autologous breast reconstruction procedures are those which use a patient’s own tissues to create the reconstructed breast. These are procedures such as DIEP flap procedure, the SGAP flap procedure or the IGAP flap procedure. There are even more acronyms, when you get right down to it. Generally the acronym identified in the procedure simply names the donor area of the body—and there are plenty of options.
Choices Can Be Problematic
Which, of course, is sometimes problematic. We like to talk about “options” for women undergoing breast reconstruction as though it’s little more than a lengthened menu, allowing women to choose precisely the procedure they want—choose the scar, choose the end result, as though it’s completely a matter of personal preference. Reality is, of course, more complex. There are many biological factors that determine which options are on and off the table. In other words, sometimes your more favored option simply won’t be feasible because of your anatomy. It also explains why there are more “standard” options—generally, reconstructive surgeons like to take muscle tissue from the abdomen area because, as a rule of thumb, it will be less missed than in other areas. Basically, taking muscle from this area leaves all your basic desired movements intact. And while this is true of most breast reconstruction procedures, there are some that bring with them some limited movement (at least for a short time, and sometimes permanently).
Doctors Let the Patient Drive
Most autologous procedures are designed to be as unobtrusive as possible, but depending on your unique physiology this isn’t always possible. So surgeons work to find a balance between costs and benefits (and, when it comes to surgery—there’s always a cost). Of course, most patients are incredibly satisfied with the end results, as evidenced by the data collected as part of the Breast-Q project. It’s also worth noting that, despite the results of the survey, there are some women who will require or desire an artificial solution when it comes to breast reconstruction. These solutions are generally less taxing, at least at first (as a donor site does not need to be necessarily commissioned).
The women recovering from breast cancer should be in the driver’s seat. But giving them options doesn’t necessarily make any of the choices easier—and it’s up to the surgeon to help guide the patient to the patient’s desired results, eliminating options that, quite simply, won’t cut it. When that is done, patients tend to have better results—but, again, the patient should be in control, as every patient is different and every desired end result is also different. At the end of the day, the Breast-Q survey will help both patients and doctors remember that.