Breast Cancer Husband by Marc Silver

Author:Marc Silver
Language: eng
Format: epub
Publisher: Potter/Ten Speed/Harmony/Rodale
Published: 2012-05-14T04:00:00+00:00

RECONSTRUCTION

That’s the term for the surgical re-creation of the lost breast. At best, reconstruction can produce a replacement breast that looks remarkably real. (If you don’t believe me, type in “breast reconstruction and before-and-after” on Google and take a look at some of those pictures.) Yet plastic surgeon Anne Nickodem, M.D., who practices in Virginia and Maryland, cautions that “there is no such thing as perfection.”

Nor will the rebuilt breast function in the same way as its predecessor. A woman in her 40s or younger may eventually gain some sensation in the new breast—allowing her to feel hot or cold or the touch of a hand. But sexual sensation never returns. Some patients don’t quite grasp that fact. Lillie Shockney is not surprised: “It looks so natural . . . it looks like a breast, it feels like a breast. So why doesn’t it have sensation like a breast?” During the mastectomy, the nerve supply to the breast is severed. That’s a clear loss for women who get a thrill from a breast caress.

Every woman who plans to undergo a mastectomy should be offered the option of reconstruction, and then decide for herself. And she shouldn’t be afraid that reconstruction will interfere with the ability to detect recurrent breast cancer. “If it did, we wouldn’t do it,” says Richard Restifo, M.D., attending surgeon in the department of plastic surgery at Yale-New Haven Hospital in Connecticut. In addition, about 1 in 20 lumpectomy patients may see a significant change in the shape of their breasts because of the amount of tissue that is removed. They, too, might want to consider reconstructive surgery.

But in some parts of the country, plastic surgeons say, patients aren’t routinely informed about reconstruction options. If your wife’s surgeon is not able to refer you to a plastic surgeon who works with breast cancer patients, she might contact the American Society of Plastic Surgeons (www.plasticsurgery.org) for referrals.

At the initial meeting with a plastic surgeon, your wife will hear about the two basic procedures to consider: an implant, or a breast made of tissue taken from another part of her body. In the complicated world of breast cancer, wouldn’t you know that Procedure A and Procedure B each has a couple of subsets, and all of the variations have their pros and cons. Your wife should understand what she’s getting into. In almost every instance, several surgeries may be required before the new breast is deemed done. In addition, many women need surgery on the other breast—reduction or enhancement—to create symmetry. By law, health insurance has covered opposite breast surgery since 1999—both for patients who have reconstruction and for those who’ve had a large lumpectomy in one breast and need to have the other one reduced to match. It’s a good idea to have a sample of the tissue removed from the other breast evaluated for “any unexpected cancer cells,” suggests breast radiation oncologist Marisa Weiss, M.D., who practices in Philadelphia.

Your wife will also have to make a decision about the timing of the surgery.

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