Prevention
Modern medicine is increasingly transitioning towards preventive care. This shift towards prevention has also been observed in breast cancer care in recent years, particularly with the discovery of the BRCA gene. Subsequently, multiple genes and risk factors have been identified. Depending on these factors, a personalized screening strategy can be chosen. Therefore, it is crucial to understand these genetic and risk factors.
Diagnosis
I was diagnosed with cancer ... This website serves as a portal designed to assist you and your loved ones in accessing personal information and finding solutions to your concerns.
The primary goal of this website is to offer guidance and support to patients as they navigate their journey toward recovery and improved quality of life. The "Diagnosis" section of our website is divided into two main categories. Firstly, under "Anatomy and Physiology," we provide fundamental knowledge about the breast. Secondly, in the "Tumors and Disorders" section, we delve deeper into various breast-related conditions.
Moreover, we aim to provide information to women who may be concerned about potential breast issues but are hesitant to seek immediate medical advice. Knowledge and information can often offer immediate reassurance if a woman is able to identify the issue herself and determine that no specific treatment is necessary. Conversely, we also strive to educate women who have received a diagnosis of a serious breast condition, such as breast cancer, and wish to approach their doctor well-informed and prepared.
Treatment
The treatment for breast cancer should immediately include a discussion about reconstruction. Our foundation has no greater goal than to raise awareness of this among patients and oncological surgeons. By making an informed decision beforehand, we avoid closing off options for later reconstruction while still considering the oncological aspect. Of course, survival is paramount, and the decision of the oncologic surgeon will always take precedence.
The "Reconstruction or not?" page contains all the information you can expect during an initial consultation before undergoing tumor removal. This page is comprehensive, and your plastic surgeon will only provide information relevant to your situation.
"Removing the tumor" details the surgical procedure itself. This is the most crucial operation because effective tumor removal remains paramount. We guide you through the various methods of removal, a decision often made by a multidisciplinary team comprising oncologists, radiologists, pathologists, radiotherapists, breast nurses, gynecologists, oncological surgeons, and plastic surgeons.
The "Breast Reconstruction" section includes information and illustrations of the different reconstruction options along with corresponding steps.
Revalidation
Those treated for cancer often need a long period to recover.
Cancer is a radical illness with a heavy treatment. Often, people have to deal with psychosocial and/or physical problems afterwards, such as stress, anxiety, extreme fatigue, painful joints, reduced fitness, lymphedema... This can have a major impact on general well-being.
There are rehabilitation programmes offered by most hospitals. We cover some of the major topics here.
Quality of life
Quality of life is a key factor in coping with breast cancer. Therefore, it is important to find coping mechanisms that work, which will be different from patient to patient. For some, it may be finding enjoyment in activities they engaged in prior to diagnosis, taking time for appreciating life and expressing gratitude, volunteering, physical exercise... Of prime importance, studies have shown that accepting the disease as a part of one’s life is a key to effective coping, as well as focusing on mental strength to allow the patient to move on with life. In this section we are addressing some topics that patients experience during and after treatment and we are providing information to address them.
Primary Breast Reconstruction
updated 6-20
Immediate or primary reconstruction is the removal of part or all of the breast gland, with immediate breast reconstruction. Since the patient does not wake up without her breast, it is associated with much lower psychological morbidity than delayed reconstruction. Combining these two major procedures results in only one surgery and a shorter overall hospital stay. This makes immediate breast reconstruction more tolerable for the patient and significantly less expensive. Several recent studies have also indicated that there is no risk of delaying subsequent adjuvant therapy.
Primary breast reconstruction has become the standard of care over the last decades. Some debate still exists on whether primary reconstruction should be offered to patients for whom postoperative radiotherapy is scheduled. It is our preference not to perform immediate autologous reconstruction when post-mastectomy radiation is definitely required. In these patients, temporary implants (baby-sit implants) are inserted that simply restore the shape and volume of the resected gland. If the breast skin envelope is large, there will inevitably be some post-operative skin shrinkage or one can perform a skin reduction at the time of the mastectomy. However, if the skin envelope is naturally small or skin has been resected, tissue expanders can be inserted. Some radiotherapy centers also prefer the expander to be deflated during irradiation. Delayed primary reconstruction is then performed six months after finishing the last radiotherapy session.
If it is unclear whether postoperative radiotherapy is required, an immediate autologous breast reconstruction can still be performed but the reconstructed breast is made 15-20% larger than the final desired size. Post-radiotherapy fibrosis and sclerosis are often associated with approximately a 10% volume loss. In addition, having some surplus tissue provides flexibility in refining the shape of the breast at a second procedure.
Benefits of primary reconstruction include:
Lower psychological impact for women: the fear of living without a breast(s) is removed. There is no loss of self-confidence, as body image is maintained.
A single surgical procedure: only one set of surgical and anesthetic complications and one recovery period.
The hospital stay after ablative (tumor removal) surgery combined with reconstruction is no longer than ablative surgery alone.
Primary reconstruction is significantly less expensive than delayed reconstruction.
Adjuvant therapy (chemotherapy, radiotherapy, hormone therapy) is not delayed.
The disadvantages of primary breast reconstruction are:
It is more difficult to plan and schedule these procedures because two teams are required - an oncological surgeon (gynaecologist or general surgeon) and a plastic surgeon.
The operation takes longer than ablative surgery alone.
There is little or no time for a patient to adapt to the loss of her breast(s). This may lead to unrealistic expectations about the aesthetic result that can be achieved by immediate reconstruction.
It can be stressful for the patient, making multiple, often difficult decisions, on whether to proceed with breast reconstruction, in addition to all the mixed emotions of a recent cancer diagnosis. Some people need or prefer more time to process the information they have received.