Breast Cancer

Breast Reconstruction Services at Continuum

As part of its comprehensive cancer care, the Cancer Center offers extensive expertise in breast reconstruction following a mastectomy. Reconstructive surgeons are involved with breast cancer cases from the beginning, working as a member of the team that helps evaluate the options -- both oncologic and reconstructive -- of patients with breast cancer.

According to Mark Sultan, MD, chief, Division of Plastic and Reconstructive Surgery at Beth Israel and a renowned expert in breast reconstruction, most mastectomy patients are appropriate candidates -- from both a medical and a psycho-social standpoint -- for reconstruction.

The decision whether or not to have breast reconstruction is a highly personal one to be reached by the patient, her family, and her medical team, including her oncologic surgeon and a board certified plastic surgeon. Often times, it is helpful for a woman to see examples of reconstructions or to meet with other reconstruction patients to understand what the process is like -- both of which can be arranged through the Cancer Center.

If you want to wait to make a decision regarding reconstruction, you may want to try wearing an external prosthesis. The nurse coordinators at the Cancer Center will work with you to obtain a properly fitted prosthesis, and will even give you a temporary prosthesis and bra. Cancer Center social workers will advise you regarding the possibility of insurance coverage for a prosthesis.

"These are the types of things that a woman may need to do to decide what's best for herself," Dr. Sultan explains.

While breast reconstruction does not need to be done immediately following surgery, the tendency over last several years is for immediate reconstructions. There are several benefits to this:

Practical Benefits. Since both mastectomy and reconstruction are done in one operation, there is only one hospitalization and one recuperation.

Technical Benefits. Plastic surgeons can perform certain procedures at the time of a mastectomy that they wouldn't be able to do later, allowing for a better reconstruction.

Psychological Benefits. Studies have shown that immediate reconstruction helps women get through this traumatic time more easily.

"The average woman today does indeed want to combine mastectomy and reconstruction into one longer, yet still safe, operation," Dr. Sultan explains.

Many women must also make the decision of what kind of reconstruction to have -- implants or autogeneous, which uses her own tissues. An autogeneous reconstruction offers a single operation and a natural result, while implant reconstruction requires two smaller procedures. Some factors in this decision include anatomy, personal wishes, and lifestyle, and any decision should be made only after a complete discussion with a plastic surgeon.

"A tremendous amount of progress has been made with reconstructions in the last decade and the procedures are safe and reliable," Dr. Sultan says. "Women should at least consider becoming educated about reconstruction to make the choice that's right for them."

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