In conjunction with Pinktober – Breast Cancer Awareness Month 2021, Motherhood Story brings you a more in-depth understanding about breast cancer treatment options, as well as what breast reconstruction surgery entails. In this article, we are privileged to have two experts in this area to shed some insights on the topic.
Dr Ho Pey Woei specialises in General Surgery & Breast Surgery at Mahkota Medical Centre, speaks to us about treatment options, support available for patients, and what to expect.
#1. What are the treatment options for breast cancer patients?
Treatment options of breast cancer will depend on the first presentation to the doctor. Mainstay of treatment is surgery, to remove the breast (mastectomy) or remove the tumour (lumpectomy).
For advanced cancer or cancer which has spread beyond the breast, more appropriately, chemotherapy first and if possible, surgery later.
#2. What is mastectomy and lumpectomy?
Mastectomy is the surgery to remove the entire breast tissue off from the chest muscle. After mastectomy without breast reconstruction, patient is flat-chested with no nipple on the operated side, a transverse scar across the chest.
Lumpectomy means the lump or tumour is removed from the breast. The breast is conserved. Patient is free to wear her normal clothing as usual after this type of surgery.
Therefore, the look and feel of the breast should be the same except, presence of a surgical scar. Patient is offered breast conservative surgery only when the doctor thinks the cancer can be adequately excised, balanced with acceptable cosmetic outcome.
#3. How can going through a mastectomy or lumpectomy devastate women?
Diagnosis and cancer treatment may cause a considerable psychological, social, and physical stress.
The purpose of surgery is to remove the cancer from the breast. Through good communication and counselling from the doctor, nurse and support group, a well-informed patient will feel encouraged and empowered to accept the diagnosis and treatment.
A cancer patient navigator is being introduced to assist cancer patients throughout their patient journey towards recovery. This role aims to assist them to understand more about their illnesses, treatment options, and how to better manage their expectations.
Aside that, Mahkota Medical Centre also works with NGOs to assist patients in their cancer journey. There is also a cancer support group in the hospital to provide emotional support for cancer patients undergoing cancer treatment and care.
#4. What are some ways that the medical industry helps post-mastectomy patients?
For women who require mastectomy, there are breast reconstruction options consisting various methods, which will improve the body image and self-esteem, and reduce the physical impact of back sore, which many patients feel after a mastectomy.
#5. Can cancer recur, and will the reconstruction affect the ability to check for recurrence?
Yes, breast reconstruction does not affect the detection of cancer recurrence.
Dr Leung Chin Meng, a specialist in Plastic & Cosmetic Surgery at Mahkota Medical Centre, provides us with more insights regarding breast reconstruction surgery and what to expect post-surgery.
#1. What is breast reconstruction and how does it work to boost confidence?
Breast reconstruction refers to surgeries to recreate new breasts after removal of the breasts due to cancer. It plays an important role in the rehabilitation of women who have lost their breasts, to make them feel whole again. By providing a mound, a well reconstructed breast would obviate the need for breast prosthesis and help to boost confidence.
#2. What does a breast reconstruction procedure entail?
Breast reconstruction can either be implant-based (using breast implant) or by using the body’s own tissues transferred from the back or lower tummy.
#3. Is it the same as cosmetic surgery?
Breast reconstruction is not cosmetic surgery. It is considered part of the overall treatment for breast cancer. Breast reconstruction can be either implant-based or by using the body own tissues.
#4. When is it advisable to have breast reconstruction done?
Breast reconstruction can be performed either immediately after removal of the breast or delayed after completion of treatment which may include radiotherapy and chemotherapy. Timing of the reconstruction depends on inputs from the breast surgeon and patient’s preference, taking into consideration the various stages of cancers.
#5. Will the breasts look natural after reconstruction?
Results varies depending on the used technique and also on the size and shape of the normal breast. Some breasts especially large droopy breasts are more difficult to match. It is not always possible to achieve complete symmetry. Expectation ought to be realistic. The reconstructed breast would look most natural when it is performed immediately after skin sparing mastectomy, using tissue from the back.
#5. What are the different options available, and how do we decide on the best?
Options on the breast reconstruction include the use of implant or own tissue. It is best decided upon consultation with the reconstructive surgeon by taking into account one’s own preference.
#6. Is breast reconstruction after mastectomy painful? How long does it take to heal?
As in all surgeries, post-surgical pain can be controlled with adequate analgesia. Healing generally takes longer after autologous breast reconstruction using own tissue. Barring any wound complications, healing usually takes 2-3 weeks.
#7. What are the risks and possible side effects of this surgery?
Side effects would depend on the types of surgery. The potential complications of implant-based reconstruction include infection, implant extrusion, deflation or rupture and firmness due to capsular contracture (implant covering becoming hard). In instances where skin is needed to be transferred from the back to provide additional skin cover for the implant, there would be scars over the back.
For own tissue reconstruction, there is the risk of poor wound healing with lost of flap if blood supplies are compromised. There may be abdominal wall weakness or hernia if the flap has been taken from the lower abdomen. Patients ought to bear in mind that some complications may prolong recovery and cause delay in commencement of adjuvant treatment, such as radiotherapy and chemotherapy.
#8. How do reconstructed breasts affect breastfeeding?
Reconstructed breasts cannot be used for breastfeeding.
#9. What can one expect post-mastectomy and reconstruction?
Patients usually can resume normal activities after one month unless there are major complications in wound healing. There is no restrictions on bra or garment after the wound has healed.
Source: Dr Ho Pey Woei, General Surgery & Breast Surgery, Mahkota Medical Centre
Disclaimer: The information provided in this article is for informational purposes only and should not be considered as medical advice from Motherhood. For any health-related concerns, it is advisable to consult with a qualified healthcare professional or medical practitioner.
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