New options for breast reconstruction

Experts say a lot breast cancer Survivors are not informed about choices

Kathleen Doheny
WebMD Health News

Reviewed by
Louise Chan, MD

September 17, 2008-Approximately 78,000 U.S. women Mastectomy Every year, but only 57,100 had Breast reconstruction In 2007, according to experts who spoke at a webinar hosted by American society plastic surgeon.

For a few women, after breast reconstruction cancer Diagnosis is simply not important, says Dr. Roberta Gartside, MD, Virginia. Plastic surgeon When breast cancer The survivor who spoke.

However, Ghatside says other women are not well informed about their options, are facing financial barriers, or both.

Post-mastectomy insurance is available, but these disorders exist, says Gartside and other speakers. Breast reconstruction Mandatory by 1998 Women’s health When cancer Rights law.

At the seminar, speakers talked about new or improved reconstruction options and what is being done to reduce barriers to procedures.

Breast reconstruction options

By far, the most popular breast reconstruction options are implants and tissue dilators, says Gartside. Other options include the use of tissue flaps or implants only.

In flap technology, the surgeon repositions the woman’s own muscles, fat, and skin to create or cover the bulge of the breast.

Tissue dilators stretch the skin to cover breast augmentation surgery.The final step may include rebuilding Nipples When Areola..

Andrea Pusic, MD, a plastic surgeon at Memorial Sloan-Kettering, says silicone implants are back “better than ever.” cancer New York center.

Once banned, silicone implants have been approved by the FDA for breast reconstruction in women of all ages Breast augmentation People over 22 years old in 2006.

A study presented at the American Society of Plastic Surgeons’ annual meeting earlier this year showed that women who received silicone implants were more satisfied than women who received saline, Pusic said. Women who receive silicone implants say they are soft and less wavy.

According to Pusic, the new generation of silicone implants (so-called “gummy bear” implants) could be even better.

She says fat injections are used to fill the malformations left by mastectomy and mastectomy.

And other studies have studied the use of Stem cells Derived from fat to correct malformations after breast-conserving surgery.

Breast reconstruction and quality of life

Studies are underway to assess the personal effects of breast reconstruction.

A new questionnaire developed by Pusic aims to quantify how breast reconstruction affects a patient’s quality of life.

Called Memorial Sloan Kettering cancer Center Breast-Q, it measures satisfaction and quality of life by examining Body image As well as psychological, social, sexual and physical functioning.

The results are expected to educate patients and doctors about the value of breast reconstruction for some women, she says.

Breast reconstruction: access problems

Amy Alderman, MD, MD, MD, Assistant Professor of Surgery, University of Michigan Medical Center, Ann Arbor, states that there are racial and regional gaps despite legislation mandating coverage and new technologies for reconstruction. ..

For example, African-American women are more likely to have half the breast reconstruction of whites, she says.

In one study, 35% of Atlanta women chose immediate reconstruction, while only 8% of Connecticut women chose.

To find out why more women didn’t choose to rebuild, city councilors searched a patient database containing more than 2,000 women in Los Angeles and Detroit, and providers were “insufficient to inform women of their options. I discovered that I did a good job.

According to her, one barrier was the lack of access to plastic surgeons for many women prior to the mastectomy. The association advocates a team approach in which general surgeons work with plastic surgeons.

If the woman is not offered a team approach, the speaker says she can first find a plastic surgeon and ask her to help form a team.

Patient’s view

In the case of Michelle fish, it was first diagnosed breast cancer At the age of 39 in 1991, “living on one breast alone was not an option.” She underwent a mastectomy and immediate reconstruction.

When she was diagnosed with cancer of the opposite breast in 2005, she was reconstructed after undergoing another mastectomy.

“”breast cancer Enough to deal with, “she says.

She says she was still at her own expense while the insurance coverage was mandatory. “In 1991, the out-of-pocket cost was $ 205. In 2005, the out-of-pocket cost was over $ 5,000.”

Fish says he had the same employer and the same health insurance for both surgeries. “There was virtually no difference between the surgeries. That’s exactly how. [much] Healthcare is escalating and how little [insurers] I’m paying

Source: Amy Alderman, MD, Assistant Professor of Surgery, Plastic Surgery, University of Michigan Medical Center, Ann Arbor. Michelle fish. Roberta Gartside, MD, Plastic Surgeon. Andrea Pussic Doctor of Medicine, Plastic Surgeon, Memorial Sloan Kettering Cancer Center, New York City. Breast Reconstruction Webinar, September 17, 2008, American Society of Plastic Surgeons.

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