Followup to New York law

As we have been reading about ramifications to the newly passed law in New York regarding providing options of breast reconstruction to individuals requiring mastectomy, I think about the continued majority of patients in this country who have not had reconstruction, either by not having the opportunity or otherwise....

New York law to educate women about breast reconstruction options

I just read that there New York Gov. David Paterson signed legislation requiring all hospitals to tell female patients about options for reconstruction after mastectomy; it is amazing that it has required a mandate for patients to find out about their options in one state..... however, I tell my patients that even in this country no more than 1/3 of patients undergoing a mastectomy have breast reconstruction, which means 66-67 percent don't have any reconstruction!

Removal of the Chemo Port!

I had a patient today who asked that we remove her chemo therapy port... as part of the steps of breast reconstruction,
we were also performing some balancing/touch-up's to the breast reconstruction and the chemotherapy port (which is placed for intravenous placement of chemotherapy medication) is often visible on the upper part of the chest under the collarbone....

regardless, there are a number of patients certainly eager to have it removed, and it is certainly a milestone in the whole process of breast cancer treatment and reconstruction!

Resources for Decision Making

Making a decision about breast reconstruction is very difficult. There are a number of choices, and it can be overwhelming in the best of times--let alone immediately after a cancer diagnosis when you are definitely not thinking your most clearly. A colleague developed this useful list of online resources for information. I would add the importance of speaking with other women who have had the kinds of surgery that you are considering. As we all know, you always hear something different from patients than you do from doctors. Ask your breast surgeon or plastic surgeon for contacts. If that does not work, please feel free to email me (hhill@bidmc.harvard.edu), and I can make the connections for you.

With thanks to Margery Gallece:

There are some good online resources.It's important to keep in mind that not all types of reconstruction are available to individuals based on factors such as treatment options, body type, etc., so it's advisable to get a couple of consults with local plastic surgeons. It's also important for women to read the small print about implants. Implants have a "shelf life" of about 10 years and should be replaced after that. This is a conversation that is often glossed over in the process of decision making. It's vitally important for women to know about that.Reconstructing Aphrodite is probably the most complete photo book (not cheap) showing reconstruction. On July 28. Living Beyond Breast Cancer had an educational teleconference scheduled on this topic: Breast Reconstruction: Understanding Your Options, Our July teleconference will help you learn about your choices for breast reconstructive surgery. This teleconference can now be heard as a podcast on their website.http://www.lbbc.org/content/event/breast-reconstruction-understanding-your-options.asp?c=educational&t=participate&sn=teleconferencesThere was a web site titled "Show Me" and a book. Some of the techniques in that book are now outdated but it was very good. You can access some of the photos and stories at this link on Dr. Susan Love's web site:http://www.dslrf.org/searchresults.asphttp://www.breastcancer.org/pictures/reconstruction/http://www.networkofstrength.org/information/treatment/reconstruction.phpThere are newer reconstruction techniques although not everyone is a candidate for these and it is not available everywhere:http://www.diepflap.com/?gclid=CPa53NS5-KICFRAN2godBWK5hg

Am I a candidate for a DIEP flap?

Patients always call asking me if they are a candidate for a DIEP flap. There are not many things that are absolute exclusions. To determine if you are a candidate, you need to come in for a consult. Even if you are overweight or have had previous abdominal surgeries, you may still be a candidate. Not all abdominal surgeries disrupt the Deep epigastric inferior perforators which make up the DIEP flap. Never assume that you cannot have one, make a consult appointment first. Your doctor will determine if you have enough belly tissue available to make an adequate breast reconstruction, and will be able to go over the probable size with you at the time of your visit.

National Survey for Women who have had Reconstruction

If you have had breast reconstruction, please take a few minutes to complete this survey from the Cancer Support Community. Your responses, all confidential, will help design more resources and information for women considering this surgery.

http://www.thewellnesscommunity.org/fm/Media/Wellnet/Summer-2010/Breast-Reconstruction-Surgery.aspx