More women opt for breast reconstruction
It can be key part of recovery for cancer survivors
Six weeks after her mother died of ovarian cancer, Elizabeth Stower, then 21, was diagnosed with Stage 3 breast cancer.
According to the American Cancer Society, 235,030 women will be diagnosed with breast cancer this year, and 40,430 will die from it. For survivors who undergo a mastectomy, life after cancer can be especially hard, mentally and physically, as they deal with a new body image. A new study by researchers from private practices and academic medical centers shows that more women are receiving breast reconstruction after mastectomies, but the rates also vary dramatically based on geographic location.
For Stower, the decision to have reconstructive surgery was immediate. During almost a year of treatment, which included chemotherapy, followed by six weeks of radiation, she had spacers placed in her chest to stretch the skin and make room for the placement of the implants.
“Now that I’m healthy again, that part of my body sort of signals health,” says Stower, now 27 and working in Washington, D.C. “If I didn’t have reconstruction, it would be a permanent reminder that something was stolen.”
“When you are diagnosed, you feel broken ... but there is sort of a rebirth after chemo and reconstruction.” Victoria St. Martin, 33
Under a 1998 federal law, most group insurance plans that cover mastectomies also cover breast reconstruction. The study published in the Journal of Clinical Oncology identified 20,506 women who had a mastectomy for breast cancer between the time the 1998 law passed and 2007. Researchers found that 46% of women who underwent a mastec- tomy received breast reconstruction in 1998. The number rose to 63% by 2007.
Study author Reshma Jagsi, a radiologist and associate professor of radiation oncology at the University of Michigan Comprehensive Cancer Center, says the law and increased awareness could be driving the increase.
“Reconstruction is an impor- tant part of treatment for survivors,” she says.
The study showed dramatic variation based on geographic location: Only 18% of women in North Dakota had reconstruction, while a high of 80% in Washington, D.C., did.
“We are seeing the difference based on location is largely associated with the number of plastic surgeons in the area,” Jagsi says.
While the majority of women in the study received implants, Susan Brown of the Susan G. Komen Cancer Society says that today, women have more options. Though more time-consuming and not right for everyone, autologous reconstruction can create breasts using fat and muscle tissue from other parts of the body.
Victoria St. Martin, 33, was working as a reporter at a local newspaper in New Jersey when she was diagnosed with breast cancer at age 30. Blogging on her website, breastcancerat30.com, St. Martin says she was blown away by the surgeries and possibilities of reconstruction.
Following a double mastectomy, St. Martin opted to have DIEP flap surgery, in which her breasts were reconstructed with tissue from her stomach through four surgeries, while receiving chemotherapy.
Reconstructions are not always smooth sailing. Even for St. Martin, two additional surgeries were needed, one to remove a cyst and another to remove dead tissue, but she says reconstruction almost served as therapy.
“In a way, mentally and physically, it fixed me,” says St. Martin, who is currently a graduate journalism student at American University and works at The Washington Post. “When you are diagnosed, you feel broken, that you and your breasts will never be the same, but there is sort of a rebirth after chemo and reconstruction.”