If you are considering a mastectomy or breast reconstruction there is much to consider before making a decision about which procedure is right for you. Dr. Joseph Disa, a plastic surgeon at Memorial Sloan-Kettering Cancer Center provides an overview of breast reconstruction options.
Hello, I'm Rene Syler, an ambassador for Susan G. Komen for the cure, and a woman with a very personal breast cancer story. You see, both of my parents had breast cancer and because of that, I opted for a bilateral preventive mastectomy in January of 2007. It was a very difficult choice for someone who didn't have breast cancer, but it was the right choice for me. If you have had a mastectomy or you're about to undergo a mastectomy, you might be considering breast reconstruction and if so, you're going to need some information to help you make that decision.
Dr. Joseph Disa from Memorial Sloan Kettering here in New York, was the plastic surgeon who helped me make my decision. Dr. Disa, thanks for joining us.
It's nice to see you.
Can you just give us a brief overview of what happens during reconstruction?
Sure. First of all, it depends on what type of reconstruction you have. There's two ways to do it. One way involves using breast implants, the other way involves using your body's own tissue. So that's one issue. The second issue is, when are you going to have reconstruction? At the time of the mastectomy or at some later time? Those are called immediate reconstruction at the time of the mastectomy, or delayed reconstruction if it's done later.
Is there one that's better than the other in terms of, you talked about the different types of reconstruction implants versus body tissue. Is that called TRAM flap?
Well that's one method. A TRAM flap is certainly one method. There's multiple different ways of using your own body's tissue to create a breast mount, and some of that involves just tissue only and some of it involves a combination of tissue plus an implant. And then there's ways to do it just with implants alone. And there definitely is not one way that's better than the other.
Is there one that has a better cosmetic outcome?
Not necessarily. It's individual depending on the patient. And that's where I would encourage patients to talk to the plastic surgeon to see what's best for them. For some patient, an implant may be superior and they may not be a candidate to use their own tissue because they may not have enough, they may have too much, there may be scars present that don't allow for it. And some women, an implant would be OK but it wouldn't necessarily match the shape of the natural breast and using the own body's tissue would be a much better way to match the feel and the shape of the natural breast.
Are there complications that you should be on the look out for?
Are they the same with both types of surgery?
More or less. Whenever you do any types of surgery, you're always worried about infection. You're worried about things healing properly. If you're using your own body's tissue and you're transferring or transplanting tissue from one part of your body-- say, your lower abdomen up to the breast area to rebuild the breast-- you want to make sure that that tissue takes. And your doctor will show you what to look for and will monitor it while you're in the hospital, and once you go home you'll be instructed on things to be aware of and what to call about.
Now I'm looking forward, after you've been a year out from your reconstruction, a couple years out, how difficult is it to screen for new breast cancers after reconstruction? Say, an implant.
It's actually straightforward. Once you've had a mastectomy, you're not going to have mammograms anymore. So the main way to screen is by physical examination, and patients are taught how to self examine themselves just like they did before. Their doctors will examine them. Both the oncologist, whether it's the surgical oncologist, the medical oncologist or both, and the plastic surgeon who follows the patient will also keep an eye and screen and look out for things. It's very straightforward. It's never been shown that having breast reconstruction will impact the future development of additional breast cancer.
But in terms of finding a new breast cancer, I guess that wouldn't be an issue though because there would be no breast tissue left.
Correct. Even if you do have a mastectomy, there is a very small risk of developing what they call a recurrence, but if these occur they typically occur on the skin above the reconstruction and are easily found.
Dr. Disa, thanks again so much for your time. Good to see you.
You're welcome, Renee. It's been a pleasure to be here.
For more information, go to Susan G. Komen for the cure at www.komen.org, or you can call Komen for the Cure's helpline 1-800-IMAWARE. I'm aware I'm Rene Syler.
Howdini is life’s little instruction manual, in HD. We’re all about bringing together the top, most respected experts in their fields to help us be the best we can be at all of the little and not-so-little challenges of our complicated lives. Howdini is the place to be for the know-how you want, when you need it. Or maybe it’s the know-how you need, when you want it. Whatever. We’re here to help. So come in and look around, won’t you?
We think you’ll love finding everything you want to learn about in one convenient place, and as we grow and add more categories and more Howdinis, you’ll be doing less surfing and more learning right here. And unlike television, Howdinis aren’t limited by time—we don’t have to break for commercials, and we’re always on.
Who is Howdini?
People often ask us, is there an actual person who is Howdini? And the answer is, it’s kind of like Lassie. Just as there were many Lassies, there are many individuals who are called Howdini. In fact, each of our experts is a Howdini, and, like all those Lassies, they really know their tricks. (Although so far there is no ‘How to tell your master that Timmy is trapped in the old abandoned mine’ segment)
Our gurus are people you know and trust because you’ve been getting advice from them for years, at places like Good Morning America, The Today Show, Money, Prevention, and Food and Wine (to name just a few). Many are best-selling authors. Others, like our medical experts, are respected leaders in their fields.
The first Howdini was Joanna Breen, who left a comfortable career at ABC’s 20/20 to create a how to video website after one too many frustrating experiences with handymen who weren’t that handy. Joanna had traveled the world reporting with Barbara Walters and others on injustice, outrage, and tragedy, but now it was time to turn her talents to dealing with crises closer to home, like what do you do if you drop your diamond ring down the drain. Joanna is the quintessential can-do girl, so she didn’t find the prospect of launching a gigantic website the least bit daunting. (Ok, that last part isn’t entirely true.)
Joanna convinced an old ABC News buddy, Shelley Lewis, to join her. Shelley had supervised roughly 9.7 million helpful how to segments during a long career executive producing television shows like Good Morning America and CNN’s American Morning. A self-described “info-pig” who loves all kinds of information programming, she is never happier than when she’s learning an amazing new tip that she can annoy share with everyone she knows. Needless to say, Howdini was a dream gig for her. A career woman, a wife, a mother, and author of two books, Shelley considers herself equally challenged by all the facets of her life.
Joanna and Shelley were introduced to marketing executive Alison Provost by a mutual friend who knew that Alison had what they needed - entrepreneurial experience, patience, and a checkbook that still had checks in it. Joanna and Shelley could see right away that Alison should join Howdini. They figured that they would take care of the programming, and Alison would bring trustworthy sponsors to help pay the bills. It took Alison significantly longer to be convinced, maybe because she was crazy busy running a marketing firm called PowerPact, which she continues to oversee while serving as the biggest of big cheeses at Howdini. But whether it’s playing Suduko or launching a new business in a field she knows little about, Alison loves the challenge of a good puzzle, It wasn’t long before she began dropping obscure internet terms like “user-interface” and “googlebot” into casual conversation.
What’s Next for Howdini?
Our goals are modest. Complete and total domination of the internet, crushing Google, Microsoft, and any other punks who get in our way. (Hey, it’s a just a goal.) But until then, we will content ourselves making the best, most professional, most credible how to videos you can find anywhere. We want to help you solve your career issues, your parenting problems, your money troubles. We want you to be more glamorous, healthier, and less stressed out. We want you to check Howdini every day for fun, interesting, useful advice from experts you know and trust.
We want to make Howdini the community you love to be part of every day, To do that, we need to hear from you. Please share your suggestions, rate and comment on the Howdini videos, and the blog, (The Howdini blog). Tell us what you’d like us to create for you.
And then, when we’ve achieved that, it’s back to working on complete and total domination of the internet.