Every October, as part of our commitment to Breast Cancer Awareness Month, we dedicate our efforts to inform, educate, and empower individuals in the fight against breast cancer.
This year, as part of our campaign, we approached 6 plastic surgeons from different parts of the world to gain valuable insights into common questions surrounding breast cancer and breast reconstruction.
Breast cancer basics: symptoms and diagnosis
Breast cancer is a serious condition that affects both women and, more rarely, men. Understanding the symptoms and being aware of the importance of early detection can significantly increase the chances of successful treatment and recovery.
Monthly self-examinations can go a long way in helping detect breast cancer early. Dr. Werner Pillkhan from Peru emphasizes that “the most common symptoms of breast cancer may include: lump, asymmetry, nipple retraction and deformities”.
It is important to remember that experiencing one or more of these symptoms does not automatically indicate breast cancer. However, early detection is crucial. If you notice any changes or have any concerns, don't hesitate to seek medical advice for your peace of mind.
How is breast cancer diagnosed? Breast cancer can be first detected either by self-examination or by screening tests.
As Dr Estrella Rojas from Peru explains, “Breast cancer is detected by ultrasound, MRI or mammography, but self-examination of the breast is also very important. Diagnosis is confirmed by biopsy.”
Early diagnosis of breast cancer is of utmost importance, as highlighted by Dr. Rincón Lozano from Mexico. “if you talk about cancer, early diagnosis allows you to have a less aggressive oncologic treatment, therefore, I will be able to use more resources to reconstruct you. If you talk about reconstruction, early breast reconstruction is an important part of the healing process”.
Early detection is also crucial for women with breast implants, and performing self-examinations is key. With or without implants, it is recommended to perform a breast self-exam monthly. The more familiarized you are with your breasts, the better you can recognize any changes.
What are the different stages of breast cancer?
Breast cancer staging is a crucial aspect for determining the extent of cancer spread and for guiding treatment decisions.
According to Dr. Gabriela Candas from Argentina “breast cancer has five stages depending on whether it is in the breast or spreads to the lymph nodes or other organs of the body”
Breast implants and Self-examination
Are there special instructions for self-examination for women with breast implants?
Dr. Gianfranco Scaperrotta, Radiologist and Breast Specialist of the National Cancer Institute of Milan explained: “Women with breast implants do not have a more complex process for breast cancer screening, but rather a more personalized one. The reason is not due to any higher risk for breast cancer: The physical presence of the implant can reduce the sensitivity of the mammogram and the ability to detect any nodules. This reduction in sensitivity is compensated by ultrasound and by relying on competent professionals ".
Dr Patricio Centurión from Perú further clarified that “there are always special instructions for each patient who has breast implants. Self-examination should be repeated regularly, and be slow and detailed. I recommend to note any details observed, including the date of self-examination.”
It is important that surgeons explain to patient how to differentiate between the implant and breast tissue.
Once there is a treatment plan for breast cancer, some patients opt to have a breast reconstruction. Breast reconstruction has many benefits that go beyond mere aesthetics. It plays a crucial role in restoring confidence, self-esteem, body acceptance and overall well-being for those who have undergone mastectomy or lumpectomy procedures. (1, 2, 3)
Breast reconstruction after breast cancer
We asked Dr Barbara Cagli, what information do you offer to breast reconstruction patients?
Dr Cagli responded that “The role of the plastic surgeon is first to inform the patients about all the types of breast reconstruction in order to allow women to choose the best technique. Nowadays there is not one technique but the best technique for each patient.
It's very important to inform the patient that breast anatomy play a crucial role especially the quality of the skin, the presence or absence of subcutaneous adipose tissue, the native shape of the breast or the presence of ptosis. Furthermore, the mastectomy technique and the quality of the flap after oncologic surgery are fundamental as well.”
We asked Dr Cagli about the types of breast reconstruction available, “in implant-based breast reconstruction (heterologous reconstruction) we have different techniques: retromuscular, partial submuscular, with mesh or ADM and pre-pectoral which is becoming in the recent years the most popular one. When the mastectomy flap has a good thickness and viability of course the pre-pectoral technique is the most natural, painless, and less invasive technique. However, in skinny patients the two-stage or submuscular techniques remain an excellent option; the technique is chosen according to the patient's breast anatomy a d type of oncologic surgery.”
Dr Giuseppe Visconti from Italy further clarified “Breast Reconstruction options vary based on patients’ features and oncologic needs. In general, we can divide breast reconstruction techniques in:
a) autologous using flaps (i.e. using the patient’s tissue, either local such as breast tissue itself in oncoplastic techniques or loco regional flaps such as contralateral breast in breast-sharing techniques, lateral thoracic region flaps or distant flaps such as abdomen, thigh and love-handles)
b) autologous using fat grafting
c) prosthetic, using breast implants.
In some cases, a hybrid reconstruction (combination of autologous options and implant) in immediate or delayed setting can be indicated.”
You can find more information on breast reconstruction in our blog post “What are the main methods for breast reconstruction?”
Follow the campaign
During October we will be sharing daily content in our social media channels, including further information about breast cancer, early diagnosis, breast reconstruction and life after breast cancer.