Breast cancer can be treated with lumpectomy or mastectomy, depending upon the size of the cancer, location, size of the breast, and genetic positivity for cancer syndromes. Oncoplastic reconstruction of lumpectomy defects involves reconstructing the patients breast with their own breast tissue. Typically the breasts are made smaller and placed into a better position. This improved position often facilitates radiation…
In patients who have undergone radiation therapy, breast reconstruction with mammary prosthesis may be challenging. Often implants may become repeatedly infected or possibly extrude from the body. When repeated infections occur or if implants extrude from the body, these patients are often not candidates for implant based breast reconstruction. The most common donor site used for breast reconstruction is the…
There are two broad categories of breast reconstruction for mastectomy. There is expander-implant reconstruction and autologous flap reconstruction. Tissue expander and implant reconstruction is often selected in patients who have not undergone radiation therapy. At the time of mastectomy, a tissue expander is placed at the location of the mastectomy pocket and often in conjunction with an acellular dermal matrix…
Patients often undergo unilateral mastectomy. In these patients, depending upon the status of the contralateral breast, the contralateral breast is often best matched with a reconstruction using the patients own body tissues. Depending on previous surgery and on previous radiation, a small portion of the abdominal skin may be transferred to the mastectomy site, not only to monitor the blood…
DIEP Flap Breast reconstruction is a unique opportunity for the breast cancer patient to loose weight. Prior to flap reconstruction, we instruct our patients to consume 80-100 grams of protein per day. There are a significant number of incisions that require healing with DIEP flap breast reconstruction and typically the metabolic rate increases after DIEP flap breast reconstruction as the…
Patients who undergo lumpectomy may require radiation in addition to their surgical treatment. Some patients are candidates for radiation therapy at the time of lumpectomy. This is called intra-operative radiation therapy and can be conducted at the time of lumpectomy. On some occasions patients may have breast cancer or pre-cancer in both breasts and can undergo bilateral lumpectomy and oncoplastic…
Mastectomy reconstruction with implants is a viable option in the non-radiated patient. The outcomes are variable and often depend on implant selection, implant size, and quality of the skin post mastectomy. We are seeing an increase in the number of patients who wish to remain the same size following their mastectomy or to go slightly smaller. I learn from my…
There are several inherited genetic mutations that may make a person more susceptible to breast cancer. Commonly encountered genetic mutations such as BRCA1, BRCA2, PALB2, and CHEK2 are identified in patient with breast cancer and those with DCIS. Frequently, these patients may wish to undergo contralateral prophylactic mastectomy. Prophylactic mastectomy is the removal of a normal breast to prevent the…
Oncoplastic reconstruction is the combination of oncologic surgery and plastic surgery. The same techniques that are used to improve the appearance of the breast can be used to allow access to remove tumors from the breast while improving the overall shape and appearance. The tumors of the breast can be localized with either…
There are several oncoplastic techniques that are used to reconstruct the breast following lumpectomy for breast cancer. These oncoplastic techniques can be utilized in conjunction with DIEP flap reconstruction for mastectomy in sequence. Patients can undergo lumpectomy for breast cancer with oncoplastic reconstruction. The staging of the lumpectomy and oncoplastic reconstruction can place a ptotic nipple areola complex in a…
