Q&A Topic: Breast Reconstruction Following a Lumpectomy
Michael H. Rosenberg, MD, FACS
Q. What is a lumpectomy?
A. It is the surgical removal of that portion of the breast containing the cancerous tumor, and the preservation of the rest of the breast, including the nipple and areola. The procedure reflects a sea-change in the treatment for breast cancer after a landmark study showed that a lumpectomy followed by post-operative radiation therapy produces survival rates equal to that of a full mastectomy. Suddenly, candidates for lumpectomies were able to save their breast.
Q. How does a woman look after a lumpectomy?
A. Some women look perfectly fine and there’s no reason to do anything else. However, often there’s a dent or a droop in the affected breast, or an obvious volume difference between the breasts, or poor nipple alignment. This creates a valuable role for reconstruction.
Q. What happens during breast reconstruction?
A. There are two possible paths. One: We make the reconstructed breast look as close as possible to how it looked originally. Two: We take reconstruction a step further. If a woman wants smaller or larger breasts, or she wants drooping breasts lifted – this is the optimum time to do that, too. Then we operate on the opposite side for symmetry. The woman ends up with the look she wants while her cancer is being cured.
Q. When is the best time for breast reconstruction?
A. There are physical and psychological advantages to having breast reconstruction as part of the operation to remove the cancer. Before post-surgery scarring, breast tissue is softer and thus easier to move around to get a better aesthetic result. In addition, the woman hasn’t yet had radiation, which may cause changes in skin tissue that can delay healing. Psychologically, it is helpful for women dealing with breast cancer to know they will look and feel like themselves again.
On the other hand, waiting to have plastic surgery is the right choice for some women. In this scenario, it’s best to wait till after radiation and healing, which places the reconstructive surgery three to six months after the original procedure.
Q. Do you recommend breast reconstruction to all women following a lumpectomy?
A. I highly recommend that every woman have a consultation about her options. By New York State statute, all women faced with breast surgery are entitled to a discussion of reconstructive surgery, and this is covered by insurance, as is the reconstructive surgery, including surgery on the opposite breast for symmetry.
Q. Are there advances in breast reconstruction?
A. All the tools we have in cosmetic breast surgery -- minimizing scars, implants, reduction, lifting -- can be used to help women with a cancer diagnosis. Northern Westchester Hospital has been at the forefront of aesthetic oncology for 15 years. We are experienced in coordinated conferencing among our medical oncologists, oncology surgeons, radiation therapists and plastic surgeons to develop a unique plan for each woman. I can’t stress enough how important it is for every woman to learn her options. Any choice a woman makes is a good one if made with knowledge.
Learn More about Dr. Rosenberg
Medical Director of the Institute of Aesthetic Surgery & Medicine,
Center for Plastic Surgery;
Associate Medical Director
Northern Westchester Hospital
Northern Westchester Hospital is a proud member of Northwell Health.