Breast reconstruction after mastectomy for many women means victory over cancer and return to normalcy. In theory, any woman who has lost a breast or part of it, regardless of prognosis for the future, has the right to undergo reconstructive surgery. In practice, due to financial limitations, the implementation of this law varies.

Reconstructive surgeries(colloquiallybreast reconstruction ) are not included in life-saving surgeries, only such surgeries are paid for by the Fund, so if the hospital exceeds the limit granted to him, the NFZ will not pay for the reconstruction. In Poland, breast reconstruction procedures are performed only in 10-15 percent. women after mastectomy. And although the NHF reimburses part of the cost of reconstructive surgery, there is still not enough money for all women to benefit from them.

Breast reconstruction: a joint decision of the woman and the doctor

The choice of the method of breast reconstruction is decided by the woman together with the doctor who will perform the procedure, or actually several consecutive treatments, which in effect allow you to rebuild the breast similar to the natural one. Therefore, every woman who makes a decision about reconstruction should answer the question: why does she want to do this? The answer is important because it allows you to accept and go through the stages of treatment without stress. Women who decide to restore the breast often say that without such surgery, they would never feel like full-fledged women, others want to avoid the hassle of wearing a prosthesis in a special bra, and yet another group is convinced that this is the only way to avoid the pain of unevenly burdened spine. For most women, especially younger women, it is a way to improve their well-being, regain self-confidence, and return to a normal life. But it is also important to know that although it is more and more often difficult to distinguish a reconstructed breast from a he althy one, it will not have a natural feeling, it will be slightly different to the touch.

Simultaneous breast reconstruction

If it is necessary to remove the entire breast, its reconstruction can be performed during the same procedure by implanting a prosthesis or an expander. But combined surgery is done in strictly defined cases. The basic criterion is the severity of the diseasecancerous. Combined operations are performed when the cancer is in its pre-invasive stage, when the risk of radiation exposure is low, and when the woman has no other cancerous disease. Simultaneous reconstruction is an ideal procedure for women burdened with BRCA1 and BRCA2 gene mutations, i.e. genes responsible for the development of breast cancer. Contraindication to the simultaneous performance of both procedures is further treatment, e.g. planned irradiation. Other contraindications are the high stage of the disease, e.g. tumor infiltration on the skin. Deferred reconstruction - sometimes after many months - is performed after the completion of adjuvant treatment. It can be performed in all women, as long as there are no contraindications to general anesthesia. It is only the patient's will that decides.

Important

80 percent lumps in your breasts are benign. You need to monitor them, visit your doctor regularly and perform the tests recommended by him. Self-examination is important in cancer prevention. It is best to do it once a month, always on the same day of the cycle. Each year, almost 15,000 patients are detected in Poland. new cases of breast cancer. The peak incidence occurs in the 5th and 6th decade of life. Only half of sick women have a chance to survive over 5 years. The reason for this phenomenon is prosaic - it is too late to seek treatment.

Breast reconstruction postponed

If the patient has undergone radiotherapy after the removal of the breast gland, her own tissue is used to reconstruct the breast. It is impossible to insert an implant or an expander under the pectoral muscle after irradiation, because this muscle is fibrotic, weakened after irradiation and will not be able to hold the prosthesis. Two techniques are normally used for deferred operations: 1. You can get the latissimus dorsi muscle (this is the muscle that runs from the shoulder blade to the pelvis). It is then sewn into the postoperative wound and a prosthesis that corresponds to the shape of a he althy breast is placed under it. The treatment is stretched over time, and the individual stages are carried out at intervals of several months. When the breast is in the right place, the nipple and the areola are recreated. If the patient does not want to undergo another treatment, she can use a silicone nipple, which she sticks to the new breast on a daily basis. Collecting the latissimus dorsi muscle is safe, as it is not of great importance for the maintenance of the correct figure. There is a scar about 12 cm long on the back, but a good surgeon will make an incision so that it is hidden under the bra strap. 2. For reconstruction, a skin-muscle flap taken from the abdomen is used. Usuallya part of the rectus muscle is taken with a piece of skin and adipose tissue from which the breast is formed. In such operations, no breast implants are implanted anymore. If the patient has not undergone postoperative radiotherapy, a procedure is performed during which an expander is implanted under the muscle. It is used when the natural breast is very large or when there is little tissue left after the amputation of the diseased breast. The expander placed under the muscle is gradually filled with more and more saline. When a sufficiently large "pocket" is obtained, which takes about 4 months, the expander is removed and the breast prosthesis is placed there. A reconstructed breast will never droop, so often the next stage of treatment is correction, or, technically speaking, symmetrization of a he althy breast to match the reconstructed one. Symmetrization can be performed during the reconstructive surgery or a few months after the first treatment.

New breast care after reconstruction

Only in the first period after the procedure, a woman must limit her arm movements, not overload it with shopping or heavy physical work. Once the scars have healed, everything returns to normal. You can go to the swimming pool, to the beach, use body cosmetics, etc. Ladies with implants should, however, protect the breast against injuries. In the first months after the reconstructive surgery, you should wear a special bra, which can be purchased at a medical store. After the breast has healed, you can wear regular underwear, but selected by a specialist, i.e. a brafitter. Regular check-ups with the oncologist cannot be forgotten. Initially, check-ups are performed every 3 months, then every six months.

Important

From the research conducted by prof. Jan Lubiński from the Pomeranian Medical University shows that breastfeeding is the best and most effective way to protect yourself against breast cancer. Each month of feeding reduces the risk of cancer by approx. 10%. This also applies to women with the BRCA1 gene that causes breast cancer.

monthly "Zdrowie"

Category:

Oncology