Losing Breasts to Cancer: A Primer on Breast Reconstruction

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She was 34 when they told her the lump was cancer. She had two young children at home and all she could think about was not dying. Once the initial shock wore off, she started to worry about what it would look like after they took her breast. It seemed almost frivolous to care about that, but the idea of living without a breast. 34 years old and deformed… constantly reminded of her cancer.

Could she wear a swimsuit anymore? Would everyone know she had cancer? Would she ever really feel like a woman again?

She came to see me in my office to talk about breast reconstruction, the process of rebuilding a breast after it has been removed. I reassured her that we could make her look reasonably normal, and that she could certainly wear swimsuits and cocktail dresses and regular underwire bras again. As a plastic and reconstructive surgeon, these conversations are part of my every day, but there are thousands of women across the country who never have the opportunity to learn about their options. 50% of women who need a mastectomy are given the option of breast reconstructive surgery, and less than a quarter of women report that they understand the full range of options available to them.

Today is Breast Reconstruction Awareness Day (BRA Day), a campaign that was created by the American Society of Plastic Surgeons to encourage a national conversation about breast reconstruction after mastectomy. 1 in 8 women will be diagnosed with breast cancer in her lifetime, and if one of those women is someone you love, here are a few basic things I want her to know about breast reconstruction.

Four things to Know about Breast Reconstruction

1. Breast reconstruction can either be started at the same time as the mastectomy (immediate reconstruction) or at any time after the cancer treatment is complete (delayed reconstruction).

2. A breast can be rebuilt one of 2 ways: using a breast implant or using tissue transferred from another part of your body (lower belly, upper buttock, inner thigh, etc). The best option for each woman is determined by her cancer stage, body shape, overall health, and personal preference.

3. Nipples can be rebuilt surgically or with 3-D tattoos (which look remarkably real- the world’s expert on this is a tattoo artist named Vinnie Myers in Baltimore, MD).

4. Your insurance company is required BY FEDERAL LAW to cover your breast reconstruction from the time of your diagnosis for the rest of your life. This mandate includes all surgeries on the affected breast AND any surgery on the opposite breast for symmetry. We can all thank the Women’s Health and Cancer Rights Act of 1998 for that!

If you or someone you know needs more information about breast reconstruction, here are some reliable resources to get you started:

Breast Reconstruction Awareness Campaign
American Society of Plastic Surgeons: Breast Reconstruction
National Cancer Institute: Breast Reconstruction Fact Sheet