Even though it was over 30 years ago, I will never forget her face.
She was a young mother and school teacher with 2 small children and I was a first-year plastic surgery resident. She had a mastectomy for breast cancer and was left with a large and painful tight scar. The implant that had been placed by my instructor under the scar was hard, unnatural, and uncomfortable…..at that time in the mid-1980s there just were not many options or choices. She looked at me and I did not know what to say to comfort her. That was the day I decided to seek post-graduate training in breast reconstruction and that young mother, with the eyes I cannot forget, changed my life forever.
This year an estimated 230,000 women in the U.S. will be diagnosed with breast cancer but less than 25% of those women will be aware of their reconstructive options before treatment. The breast cancer experience touches not only those women but also their spouses, their children, their families and their lives for years. The breast cancer experience involves much more than just removing a tumor or having a mastectomy, it is a journey that can involve medical and other post-operative treatments as well as impact a women’s personal life and self-confidence and relationships at every level. In short it will someday effect all of us and someone we love.
The really exciting news is that the breast cancer experience is changing significantly for the better for a variety of reasons:
– Education and Patient Awareness – public awareness and educational efforts by a number of professional organizations have resulted in women being more informed and aware of their options. The American Cancer Society, the American Society of Plastic Surgery, the Susan G. Komen Foundation, The Victory Center and many others are doing an incredible job of communicating useful information to patients and their families. The best-informed patients make the best choices!
– Identifying Risks and Cancer Prevention – the most effective way to fight cancer is prevention. New research on nutrition and life style as well as genetic testing to quantify risk factors have actually made a substantial difference in breast cancer incidence. Advances in genetic mapping have made great progress and resulted in improved options and treatment outcomes for patients at risk. Prophylactic mastectomy or removing the breast tissue to prevent cancer in high risk individuals, as popularized by actress Angelina Jolie, can reduce cancer risk by 90-95% in appropriate patients and result in excellent aesthetic outcomes. We encourage everyone to learn more about these exciting advances in order to protect themselves and their families.
– Early Detection – After prevention, the next most effective way to impact breast cancer is early diagnosis. Improved patient education and self-exam, consistent doctor’s visits, advances in imaging techniques such as mammography, ultrasound, MRI and other scans have resulted in earlier detection of breast cancer and breast ‘pre-cancers’ which will improve the overall patient experience and outcomes as well as reduce breast cancer morbidity.
– Improved Surgical and Reconstructive Techniques – Significant advances in biomaterials for breast implants and implantable materials (acellular dermal matrix) to help shape breast reconstruction procedures, have resulted in much more natural breast shapes as well as improved safety and less recovery. Earlier detection and research on tumor biology have resulted in less invasive resection procedures (lumpectomy and mastectomy) and options such as sparing the breast skin and nipple in appropriate patients. Placement of implants above the chest wall muscle (pre-pectoral reconstruction) and advances in tissue flap surgery reduce recovery time and have improved results for patients dramatically.
– Post Treatment Quality of Life Improvement – the consequences of breast cancer treatment do not stop after the procedures have ended. Many patients taking estrogen-blocking medication or other targeted chemotherapy or radiation deal with side effects such as bone and heart health, hair loss, premature skin aging, tissue dryness and laxity, post-menopausal vaginal dryness and urinary incontinence. This often results in femininity and intimacy challenges, sexual difficulties and overall loss of self-confidence and intimacy. New advances in clinically proven topicals, non-estrogen growth factors and other therapies can reduce symptoms and help restore confidence and vitality. Regenerative treatments with platelet rich plasma (PRP) and other stem cell growth factors as well as collagen stimulating noninvasive technologies have given many patients much improvement in these issues and a better quality of life.
October is Breast Cancer Awareness month and October 17th is Breast Cancer Awareness Day (or ‘BRA Day’). Please support these worthwhile programs and help bring more awareness, education and encouragement for the many women, men and their families that are dealing with this life-changing issue. We invite you to join me and the evolv staff at Rosie’s on Wednesday, October 17th to support BRA DAY and spread the word on improving awareness and quality of life for breast cancer patients and families.
Yes the breast cancer experience is changing for the better and helping improve the quality of life for many. Advances in clinical research, cancer biology, genetic testing, surgical and reconstructive option have transformed the breast cancer experience in such positive way. The quality and safety of new reconstruction choices and postoperative treatment options can restore a patient’s self-confidence and lifestyle. As plastic surgeons we now may often hear a post reconstructive patient say, “Doctor, I sometimes forget I had a mastectomy!”
And I am forever grateful to that young mother and cancer survivor that inspired me with her courage so many years ago.