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Where are you in your care?

Diagnosis of cancer and treatment

The diagnosis of breast cancer starts a pathway for treatment to remove all the cancer. Almost all women will need a combination of chemotherapy, radiotherapy, surgery, hormonal or biologic therapy. At this point, you may be thinking about breast reconstruction surgery.

Appointment with a breast reconstruction surgeon

This may take place before or after the mastectomy. The surgeon will talk to you about the different surgical and non-surgical options. The best option and time for you to have the surgery will depend on several factors. Your lifestyle, cancer size, need for other treatments and treatment preferences need to be considered. The surgeon will talk to you about all of these. Above all, the top priority is making sure your treatment plan will give you the best chance of being cancer free.

Timing of your breast reconstruction option

Breast reconstruction can be done at the same time (Immediate)
as the mastectomy or at a later time (Delayed).

Immediate breast reconstruction may have a psychological benefit, as you will not have a period of time with "no breasts". A lot of organization is needed to have this done at the same time as the mastectomy. Because of this, only a limited number of breast centers are able to offer this service. The following are examples of situations that may be considered for immediate reconstruction:

  • Low chance of needing radiotherapy after surgery
  • Smaller tumor size (example: less than 2 cm)
  • Diagnosis of a non-invasive cancer or pre-cancer (DCIS)
  • Diagnosis of a non-inflammatory, non-locally advanced cancer
  • Lymph nodes in your armpit (axillary lymph nodes) do not have cancer
  • Likely to obtain clear margins
  • You are well enough to have a general anesthetic
  • Preventive mastectomy

Delayed reconstruction is done after the mastectomy has healed. This can be done months or even years after the mastectomy.
Most breast centers offer this service. The following are examples of conditions that may be considered for delayed reconstruction:

  • You are tumor-free and treatment of your breast cancer (chemotherapy, radiotherapy) is finished
  • You are well enough to have a general anesthetic
  • Radiotherapy has been completed at least 6 months prior to surgery

What if I only had a partial breast defect?

The main goal of breast reconstruction is to create a breast that looks nice and matches the other one.

A breast lift or breast reduction can be done to correct the shape and size of the other breast to help match the partially removed breast.

A breast lift, a breast reduction, an implant or flap tissue can also be used in women who had only a part of their breast removed (lumpectomy, partial mastectomy) to improve the shape of the partial breast defect.

No partial breast defect is the same, every single one needs to be evaluated on a individual basis by a surgeon close to you.

What if I had both breasts removed?

Sometimes women had cancer in both breasts or want the other breast removed to reduce the risk of getting another cancer. The options for reconstructing a breast after preventive mastectomy are the same ones described above.

Reasons for removal of the other side:

  • Breast cancer gene carriers contain types of breast cancer which are known to occur in both breasts
  • Strong family history of breast cancer
  • The original cancer was not found by mammograms or other tests
  • Woman's decision after careful consideration of her breast cancer risk

Pros:

  • Easier to have both sides look the same (Symmetry)
  • One surgery and hospital stay
  • Lower chance of getting breast cancer

Cons:

  • For abdominal flaps: only 1/2 the abdominal tissue can be used for each breast. Implants, tissue expanders, or back tissue may be needed to make the breast the right size.
  • Longer surgery compared to one breast
  • Higher complication rates
Review your breast reconstruction options