October 6, 2013
Laura A. Klein, M.D., Medical Director, The Valley Hospital Breast Center
Actress Angelina Jolie’s high-profile announcement about her decision to have a preventive double mastectomy after learning she carried a genetic mutation that put her at high risk for breast cancer helped ease the unreasonable social stigma long associated with the procedure. It also put a spotlight on advances in breast surgery and reconstruction.
For many women, the thought of undergoing a mastectomy – the surgical removal of one or both breasts – is understandably terrifying. But the techniques for performing a mastectomy and breast reconstruction have both come a long, long way.
In my practice I am seeing an increasing number of women at younger ages who are opting for mastectomies, either because of a breast cancer diagnosis or as a preventive measure when they are at a heightened risk for cancer. This is in part because there are excellent options for surgery and reconstruction that weren’t available in the past.
One of the most significant advancements is called a nipple-sparing mastectomy. This procedure removes all the breast tissue but leaves the breast skin, including the nipple and areola, intact. This is followed breast reconstruction. The result? A very natural looking breast with minimal scarring.
Not every woman will be a candidate for the nipple-sparing technique. But the criteria for patient selection are greatly expanded with the availability of a multidisciplinary breast surgical oncology and plastic surgical team and state-of-the-art imaging to properly select the patients.It is considered an excellent option for women without breast cancer who choose to have risk-reducing surgery, allowing them to obtain the best cosmetic results possible, with a natural result.
Following a mastectomy, there are many good options for breast reconstruction. Some are performed in a single operation; others require more detailed cosmetic interventions. The key to the best cosmetic outcome is working with a team of highly specialized plastic surgeons, who are well trained in all forms of reconstruction and can select the option best for each individual patient, taking into consideration not only the disease process, but also the lifestyle and concerns of the patient.
The bottom line: Our goal is limited surgery and breast preservation as much as possible. But when mastectomy is the best choice it is important to understand that there are many different options for surgery and reconstruction that result in a very good, natural-looking outcome.
Learn more about The Valley Hospital Breast Center