Prevention
Modern medicine is increasingly transitioning towards preventive care. This shift towards prevention has also been observed in breast cancer care in recent years, particularly with the discovery of the BRCA gene. Subsequently, multiple genes and risk factors have been identified. Depending on these factors, a personalized screening strategy can be chosen. Therefore, it is crucial to understand these genetic and risk factors.
Diagnosis
I was diagnosed with cancer ... This website serves as a portal designed to assist you and your loved ones in accessing personal information and finding solutions to your concerns.
The primary goal of this website is to offer guidance and support to patients as they navigate their journey toward recovery and improved quality of life. The "Diagnosis" section of our website is divided into two main categories. Firstly, under "Anatomy and Physiology," we provide fundamental knowledge about the breast. Secondly, in the "Tumors and Disorders" section, we delve deeper into various breast-related conditions.
Moreover, we aim to provide information to women who may be concerned about potential breast issues but are hesitant to seek immediate medical advice. Knowledge and information can often offer immediate reassurance if a woman is able to identify the issue herself and determine that no specific treatment is necessary. Conversely, we also strive to educate women who have received a diagnosis of a serious breast condition, such as breast cancer, and wish to approach their doctor well-informed and prepared.
Treatment
The treatment for breast cancer should immediately include a discussion about reconstruction. Our foundation has no greater goal than to raise awareness of this among patients and oncological surgeons. By making an informed decision beforehand, we avoid closing off options for later reconstruction while still considering the oncological aspect. Of course, survival is paramount, and the decision of the oncologic surgeon will always take precedence.
The "Reconstruction or not?" page contains all the information you can expect during an initial consultation before undergoing tumor removal. This page is comprehensive, and your plastic surgeon will only provide information relevant to your situation.
"Removing the tumor" details the surgical procedure itself. This is the most crucial operation because effective tumor removal remains paramount. We guide you through the various methods of removal, a decision often made by a multidisciplinary team comprising oncologists, radiologists, pathologists, radiotherapists, breast nurses, gynecologists, oncological surgeons, and plastic surgeons.
The "Breast Reconstruction" section includes information and illustrations of the different reconstruction options along with corresponding steps.
Revalidation
Those treated for cancer often need a long period to recover.
Cancer is a radical illness with a heavy treatment. Often, people have to deal with psychosocial and/or physical problems afterwards, such as stress, anxiety, extreme fatigue, painful joints, reduced fitness, lymphedema... This can have a major impact on general well-being.
There are rehabilitation programmes offered by most hospitals. We cover some of the major topics here.
Quality of life
Quality of life is a key factor in coping with breast cancer. Therefore, it is important to find coping mechanisms that work, which will be different from patient to patient. For some, it may be finding enjoyment in activities they engaged in prior to diagnosis, taking time for appreciating life and expressing gratitude, volunteering, physical exercise... Of prime importance, studies have shown that accepting the disease as a part of one’s life is a key to effective coping, as well as focusing on mental strength to allow the patient to move on with life. In this section we are addressing some topics that patients experience during and after treatment and we are providing information to address them.
Practical Issues
In addition to medical aspects, breast reconstruction also involves other aspects.
Financial issues
Funding by public health care systems or by private insurance companies can vary enormously and depends mainly on local policy.
For example, in Switzerland and the United States, private insurance companies will only agree to reimburse procedures if prior approval is obtained. Your plastic surgeon needs to submit this request for reimbursement.
However, in many countries breast reconstruction is a legal entitlement and insurance companies need a strong argument to refuse to pay. However, if a very low fee is offered, it may not be financially viable for hospitals to perform this surgery.
In countries with public health care systems like Belgium, France, Ireland, Italy and the United Kingdom prior approval is not always necessary. Unfortunately though, hospital reimbursement remains low. This can make it difficult to find a large number of centers that offer all the options for breast reconstruction. There is also a temptation for hospitals to provide only the most lucrative techniques, instead of the most appropriate procedure for the patient.
Therefore, in some countries additional fees may be charged to supplement the fees provided by the public health care system. This insures that all patients are offered the most appropriate reconstructive technique. These extra funds can be provided by your own additional private insurance or may need to be self-funded.
We suggest that you talk to your surgeon or the office staff about the financial implications of your surgery. Also read your insurance policy carefully and make sure that you fully understand your level of cover.
Absence from work
The total amount of time that you are off work is determined by the ablative surgery required, your reconstructive technique and the need for adjuvant therapy.
1. Patients undergoing immediate reconstruction
A. After breast conserving surgery
Remodeling or loco-regional flaps do not add to the time off work. After a healing period of 3 – 4 weeks, radiotherapy is required for the next 5 – 6 weeks.
A few additional weeks recovery may be needed after the adjuvant treatment.
B. For a partial or total mastectomy
Without reconstruction or adjuvant therapy, the recovery period is around 3 – 4 weeks.
If an immediate reconstruction is performed, the total time off will be about 6 weeks.
If additional adjuvant therapy is required (chemotherapy or radiotherapy), the total recovery time is more substantial.
Radiotherapy generally adds 5 to 8 weeks while chemotherapy may add 6 months.
2. Patients undergoing delayed reconstruction
For both implant based and autologous reconstruction, a 6 week recovery period is necessary.
Returning to full daily activities is much easier following perforator flap breast reconstruction because muscle function and strength are preserved.
Surgeon
In immediate breast reconstruction, the surgery is performed by two teams, often from different specialties. The removal of the tumour, the breast gland and/or axillary node(s) is done by a surgical oncologist. This can be a general surgeon, gynaecologist or plastic surgeon. Simultaneously or immediately afterwards, plastic surgeons perform the reconstruction using either an implant or autologous (own body) tissue.
In delayed breast reconstruction, two teams of plastic surgeons are involved. One group prepares the recipient site by opening the existing scar, creating a pocket to contain the new breast and dissecting the internal mammary vessels. At the same time, the second team harvests the flap. After transferring the tissue and performing the microsurgical anastomosis, both teams then help to close the remaining wounds. In implant based reconstruction, only one team of plastic surgeons is required.
Plastic surgeons are specialized physicians who, after completing a medical degree, undergo intensive training in both general (3-6 years) and plastic surgery (3-5 years). They specifically perform complex reconstructive procedures and are equipped to deal with any possible complications. Not all plastic surgeons have experience in breast reconstruction and it is wise to check beforehand. It is also important that you identify who will be responsible for your surgery and post-operative care.