2.3 Breast Reconstruction Surgery

2.3.1 Breast Reconstruction Surgery

Your choice to have breast reconstruction surgery is a personal decision (Canadian Breast Cancer Network [CBCN], 2022). Some women have this surgery done to improve their self-image, while others do not want a reminder of their breast cancer.

2.3.2 Immediate & Delayed Reconstruction

There are two different timing options for breast reconstruction surgery: immediate and delayed (Lymphedema Working Group, 2012).

Immediate reconstruction occurs at the same time as your breast cancer surgery (Lymphedema Working Group, 2012). After your surgeon removes the tumour in your breast(s), a plastic surgeon will complete the reconstruction surgery. On the other hand, delayed reconstruction occurs after all breast cancer treatments have finished and you have healed. The timeline for this reconstruction could be anywhere from 6 to 12 months after your breast cancer surgery.

Which One Should I Choose?

Before you decide on your preferred breast reconstruction surgery timing, consider the following factors.

If you have stage I or II breast cancer, then you are more likely to have the option of immediate reconstruction (Lymphedema Working Group, 2012). Radiation can cause unexpected changes in the reconstructed breast, such as skin discolouration or shape changes.

If you have stage III or IV cancer, then your options will be limited to delayed reconstruction (Lymphedema Working Group, 2012). At these stages, lymph nodes are usually affected, and, as such, radiation treatment is more common. Furthermore, you can delay radiation treatment if you are healing from an immediate reconstruction surgery, and recurring cancer may be harder to detect.

2.3.3 Types of Reconstruction Surgery

You have a couple of options to choose from for breast reconstruction surgery.

Breast implants are one type (CBCN, 2022). Some breast implants involve placing a silicone casing filled with salt water or silicone gel under the chest muscle. The risk of this surgery is breast implants could shift, leak, wrinkle, or change shape.

Autologous reconstruction, which creates a new breast using your own body tissue, is the other type (CBCN, 2022). This procedure would involve taking tissue, muscle, and fat from other areas of your body and then placing it into your chest. The risk of this surgery is potential weakness in the donor site (e.g., upper back or abdomen) due to the removal of muscle there.

After 3 to 6 months post-surgery, your nipple and areola can be reconstructed (CBCN, 2022).

Image 14 shows an illustration of breast reconstruction after a mastectomy, using a breast implant (National Cancer Institute, 2013b).

Image 14

Breast reconstruction implant