Reconstruction, YES or NO?
If you opt for a mastectomy, you should be offered reconstruction – either using tissue taken from another part of your body and/or a silicone implant – which can be done immediately if the rest of your treatment allows, or at a later date. Some women with conditions that can lead to complications post-surgery may be advised against reconstruction and, if you have radiotherapy after mastectomy, you’ll probably be advised to delay it for a year. It’s a major decision and, perhaps surprisingly, less than a third of women have immediate reconstruction after mastectomy. If you have an immediate reconstruction it may give a more natural result, as the surgeon can use most of your existing breast skin, but it doesn’t leave you much time to think it through. Reconstruction means you won’t have to wear a prosthesis and can help your confidence, but it involves two to three major operations, you may have very little sensation in the new breast and scarring if tissue is taken from elsewhere in your body. It won’t give you a ‘perfect’ breast but many women are happy with the results and you can have balancing surgery on the other breast so that they look even. If you’re feeling unsure, talk to organisations that support women who have had a mastectomy: keepingabreast.org.uk and flatfriends.org.uk
If you delay the reconstruction decision, do speak to your surgeon if you think you may want reconstruction in the future. Although guidelines say there should be no time limits on breast reconstruction or access to balancing surgery, new research by Breast Cancer Now shows that some clinical commissioning groups are restricting women’s access by capping the number of surgeries they can have, putting time limits on surgery or limiting availability of balancing surgery.
QUESTIONS TO ASK
◆ Can I talk to a plastic surgeon before surgery about the options for reconstruction and see some pictures?
◆ Will I need surgery to the other breast?
◆ How well will reconstruction work for me – how successful is it likely to be in terms of appearance?
◆ How many operations will I need and how long will my recovery take?
‘IF YOU’RE UNSURE, TALK TO SUPPORT GROUPS FOR WOMEN WHO HAVE HAD A MASTECTOMY’