Breast reconstruction following a mastectomy is now an integral component of the treatment process for breast cancer.

Every woman having treatment for breast cancer, and for whom reconstruction is an option, should have the opportunity to discuss reconstruction with a plastic surgeon even if it means going to another  hospital to have it.

What is breast reconstruction?

If you need to have surgery to remove a breast cancer, reconstructive surgery aims to rebuild your breast, either wholly or partially, to match the normal breast in both shape and size. It also aims to improve your body image and self-esteem, helping the process of recovery on a physical, emotional and psychological level.

Current evidence suggests that breast reconstruction, either at the same time or after cancer treatment, does not in any way increase the chances of the cancer recurring.

There are several surgical ways to reconstruct a breast, some relatively simple, some quite complicated.

It is essential that you are assessed and informed of the technique that would be best for you by someone who knows about all the options. You should be able to choose your preferred option, even if it means travelling to another hospital to have it carried out. As awareness of the range of choices and benefits of breast reconstruction grows, there is more demand for it: as a result, plastic surgeons have become an integral part of the teams treating women with breast cancer

What causes breast cancer?

• Breast cancer is the most common form of cancer affecting women throughout the world.
• Cancers occur when normal cells stop responding to the control systems used to co-ordinate the function of cells. These rogue cells start to multiply faster than they should, forming cancerous tumors.
• Why this happens is the subject of much research and debate, but is probably a combination of environmental, lifestyle and genetic factors.
• The treatment of breast cancer is based on the elimination of these cells, whether through surgical removal or by killing them with radiotherapy and/or chemotherapy.
• The type of treatment you will be offered depends on the exact type of breast cancer you have, and if any cancerous cells have spread within and beyond the breast. Your breast surgeon or breast care nurse will discuss the treatment options available for you and will help guide your decision.

What is a mastectomy?

• This is the surgical removal of the entire breast. About 40% of women diagnosed with breast cancer require or choose to undergo mastectomy.
• The breast is positioned between the skin of the chest and the chest wall muscles, and consists of milk ducts, glands, fat and some connective tissue holding all of these components together.
• The glands produce milk, which runs via the ducts to the nipple.
• As the nipple is connected to the entire breast and the cancer can involve the ducts, the nipple must usually be removed as part of the mastectomy surgery.

Mastectomy is still the best treatment for women with certain types of breast cancer. Your breast cancer surgeon will discuss this with you, but generally a mastectomy is recommended if

• Cancer is present in two or more areas of the breast
• The breast has been treated in the past with radiotherapy
• A large tumor is found in a small breast
• The tumor is likely to recur.
• On discovering cancer within one breast, many women prefer to have that entire breast, or even both breasts, removed to reduce the risk of getting another breast cancer in the future.

Another important consideration is whether your other breast can be matched as it is or if it would be better to adjust it, perhaps by lifting it or making it smaller. All of these things will be taken into account by the plastic surgeon before a decision can be made as to what options are available for you to choose from.