Breast Reconstruction General Information
The Women’s Health and Cancer Rights Act of 1998 was enacted on October 21, 1998. This federal law mandates that group health plans and individual health policies that provide coverage for mastectomies also provide coverage for breast reconstruction following the mastectomy(ies) and any other contralateral procedure for symmetry.
This significantly empowered and gave women the option that they were never given in the past and to have the ability to decide if breast reconstruction was the right option for her. Huge strides have been made in this arena as well as a big push towards education of this option for all women following breast surgery for cancer. Prior to this push, it was seen that nearly 70-80% of all women diagnosed with cancer did not even know that reconstruction was an option…today, that number has fallen to approximately 50%.
Breast Reconstructive Procedures:
There are two basic categories for reconstructive procedures used to recreate a breast:
· Implant-based: permanent silicone or saline implants are utilized to recreate a breast mound
Breast implants are a great option for breast reconstruction and can achieve an excellent result in certain candidates
· Flap-based: your own tissue along with its blood supply from one area of your body is transferred to your breast area to recreate a breast
Utilizing a flap for reconstruction gives the benefit of using your own tissue for reconstruction of a breast. A flap often looks, feels, and moves more naturally than an implant alone. Most importantly, the flap also provides an added advantage of bringing in healthy, well-vascularized tissue to the breast area, which is beneficial for irradiated or compromised areas at the mastectomy defect. Flaps ameliorate some of the healing issues before or after radiation therapy by incorporating a remote source of blood flow, thus avoiding some of the potential complications with implant-based reconstruction.
The next posts will discuss the pros and cons of each of the above procedures as well as a thorough discussion describing the advantages and disadvantages of the above, including timing, effect on recurrence rates, surveillance, etc.