Interesting Article on Breast Reconstruction & My Thoughts

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I have not had implants and if you have been following me you know I, myself, have not had breast cancer so do not have first hand experience with reconstruction. I have, however, been witness to my mothers journey with it and prior to her getting cancer in her liver and bones 5 1/2 years later we went through quite a bit with her reconstruction.

The first thing I can say is, ALWAYS check out the surgeon you have chosen. Ask them for references of patients willing to share their experience. Whether you are getting your surgery done with the NHS or privately you certainly have the choice and don’t let them tell you otherwise. I learned through my mothers experience the price we pay for making a hasty choice. My mother did not do any research and chose the very first surgeon on the list. This later turned out to be a massive problem. That surgeon was very bad at his craft and proved to make the implant look considerably different than the natural side, notable even when wearing her clothes.

When my mother called me sobbing uncontrollably about being ‘deformed’ I thought she was being dramatic but when I arrived to her home a few days later (I lived 9 hours away and needed to arrange leave from my military job as an aircraft mechanic) I realised that she was very accurate in her description. My mum later described it as having a water balloon on one side and a natural breast on the other. So if you take away anything from this post, please make your decision carefully and look for these surgeons on a Google search. You’d be surprised how much you can find out about a surgeon gone wrong that way!

I am posting a link to an article by my, of late, a popular article writer:
St George’s Hospital, The Princess Grace Hospital. He has written some very helpful articles on breast health and surgery. Have a look at this article: http://www.totalhealth.co.uk/clinical-experts/professor-kefah-mokbel/reconstructive-surgery-following-mastectomy-breast-cancer

He has a very simple way of explaining and I like that. I work with breast cancer survivors one to one helping them regain confidence after having been through mastectomy. At any stage during or after. Please feel free to comment, share or even contact me if you would like to speak further about my offering. I am very very focused on helping women to feel confident and vibrant again. Have a wonderful day!

Ever Worry About Extreme Breast Pain?

It’s not uncommon to get breast pain mid-cycle or during cycle but did you ever get such bad pain that you wondered if there might be a problem? Well, Professor Kefali Mokbel has done another article that really is concise and helps explain the possibilities that are given for the different types.

I post these articles to give you the confidence to know that not all pain is attributed to breast cancer. I also do a lot of reading into people’s articles that are online to see if there is anything of value and I understand that not all women reading my blog have breast cancer and possibly have just found a lump or are having symptoms and wondering about their symptoms and what they might mean.

Please share and like if you found it of value. I am very focused on helping women and empowering women who have gone through breast cancer and this blog is one part of what I do to help survivors. I offer coaching one to one and very unique retreats for groups under 10 women. Please feel free to let me know if you’re interested about any further information. Have a look at this article and see if it fits for you. I would love to have your responses, comments or feedback on this to tell me if you find it useful.

http://www.totalhealth.co.uk/clinical-experts/professor-kefah-mokbel/understanding-causes-breast-pain

New Skin Sparing Mastectomy!

Really exciting new technology going on around skin-sparing mastectomies. See the article Professor Mokbel has written below and the link to his site and referencing the article is below. I find this new technique to be very interesting and his article is thorough. See what you think and please comment below, and share if you would like.

Introducing skin-sparing mastectomy

Article written by
St George’s Hospital, The Princess Grace Hospital

Both immediate and delayed breast reconstruction provide enormous benefits for women undergoing mastectomy for breast cancer. Skin-sparing mastectomy (SSM) has become a valid option for women who are undergoing mastectomy and immediate breast reconstruction for early breast cancer. The reason for this is that conventional non skin-sparing mastectomy (NSSM) often results in prominent scars on the new breast and a paddle of skin that is of a different colour and texture to the natural skin. With SSM most of the natural skin envelope is preserved during the immediate breast reconstruction leading to a much better aesthetic outcome. It also reduces the need for surgery on the other breast, which may otherwise be required to give a symmetrical appearance.

Is it safe?

Compared to NSSM the procedure of SSM seems to be safe for women undergoing mastectomy for invasive breast cancer smaller than 5cm in size and non-invasive breast cancer (known as DCIS), or risk reduction. However with more advanced cancers, there is probably less of a role for SSM due to the high probability of the need for post-mastectomy radiotherapy and the lack of medical data covering this.

Can the nipple be saved during mastectomy?

The nipple can be saved during skin-sparing mastectomy in selected cases. If the tumour is more than 2cm away from the nipple and the tissue behind the nipple is free from tumour then it is safe to save the nipple.

Radiotherapy after skin-sparing mastectomy

Most women undergoing mastectomy for breast cancer do not require radiotherapy following their surgery. However, patients with several positive regional lymph nodes and/or large tumours are offered radiotherapy in view of the proven reduction in recurrence and improved survival that it gives. The use of post-mastectomy radiotherapy has recently been on the increase and this has raised questions concerning both the effects of radiotherapy on a reconstructed breast and also the potential for the reconstructed breast to interfere with radiotherapy delivery. There are currently a lack of medical trials concerning the use of radiotherapy after SSM and immediate breast reconstruction and the published data that exist are based on very small numbers and vary quite considerably. It is accepted however, that radiotherapy following immediate breast reconstruction is associated with a higher rate of complications. The other concern regarding radiotherapy in the reconstructed breast is related to the use of implants. The scar tissue in particular often causes subsequent shrinkage of the reconstructed breast around the implant. One medical study compared 39 patients who received radiotherapy following implant and reconstruction, with 338 non-radiotherapy reconstructions and found that there was a significant negative impact on the reconstructive outcome with implants. The main complications were shrinkage and pain. Shrinkage results in poor appearance and sometimes requires further surgery. This has led some surgeons to recommend that immediate breast reconstruction be avoided if it is known that a patient is likely to require post-operative radiotherapy.

However, more recently, in an analysis that my colleagues carried out to evaluate unilateral postoperative chest wall radiotherapy in patients who had bilateral tissue expander/implant reconstruction, it was observed that in most patients although the shrinkage was higher on the irradiated side, overall symmetry, appearance and patient satisfaction remained high. In only 10% of the patients was shrinkage of the irradiated breast clinically significant. These observations are consistent with our experience, and support the notion that immediate breast reconstruction using tissue expansion and implants is an acceptable option for women undergoing mastectomy for breast cancer. Moreover, any clinically significant scarring around the implant known as capsule formation can be treated with surgery.

Despite the higher incidence of complications associated with post-mastectomy radiotherapy, most patients remain highly satisfied with immediate breast reconstruction. In addition, the adverse effects of radiotherapy on skin-sparing mastectomy and immediate breast reconstruction can be minimised by optimising radiotherapy delivery and by placing a saline filled tissue expander under the pectoral muscles in the chest in order to help delayed revision of reconstruction using an implant. This new concept, known as immediate-delayed reconstruction, can avoid the aesthetic and radiation delivery problems that can occur after immediate breast reconstruction.

We have recently conducted a study to evaluate the clinical outcome and patient’s satisfaction in approximately 100 women who had SSM and immediate reconstruction at The London Breast Institute. Our study confirmed the safety of this technique and showed a very high level of patient’s satisfaction (average score 9.5 out of 10). The complication rate was low and post-mastectomy radiotherapy did not compromise the high level of patient’s satisfaction.

Conclusions

The current evidence suggests that post-mastectomy radiotherapy is an acceptable option with skin-sparing mastectomy and immediate breast reconstruction in the multi-disciplinary setting. Although post-mastectomy radiotherapy is associated with a higher rate of complications, a satisfactory cosmetic outcome can be achieved in most patients.  However, until better methods of radiotherapy delivery are developed to minimise complications, women at high risk of requiring post-mastectomy radiotherapy can be safely offered skin sparing mastectomy and immediate breast reconstruction using a saline-filled tissue expander and this can be replaced with a permanent prosthesis or converted into a flap reconstruction after the completion of the radiotherapy. Any scarring tissue formation around the implant can be surgically treated at this stage. This new concept, known as immediate-delayed reconstruction, can avoid the cosmetic and radiotherapy delivery problems that can occur after immediate breast reconstruction. Furthermore, prior radiotherapy does not represent a problem to skin-sparing mastectomy and immediate breast reconstruction, it does however increase the incidence of complications.

http://www.totalhealth.co.uk/clinical-experts/professor-kefah-mokbel/skin-sparing-mastectomy-breast-cancer

Found A Lump But Turns Out It Was A Cyst?

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My first experience with finding a lump was so scary, especially after having just watched my mother pass on from it. The family history is so high with breast cancer on both sides that finding a lump for the first time was a massive scare and put me into a bit of a shock. I wasn’t sure what to do, I mean, obviously you go get a mammogram and have the experts figure it out but I really felt like I was frozen. Like maybe it was not really there and maybe if I ignore it, it won’t really be there.

So, after a lot of processing that stuff (I was 35 when I found the first lump) I finally made an appointment and went in and got a mammogram. It was not fun as I am sure you know if you have had one. My sister said to prepare to feel like your boob was just put under a car tire and run over a few times. She was definitely not lying about that! Ouch! They put you in a hospital gown and have you move around in the cold x-ray room to position yourself in different positions. You end up being more personal with the technician than you really cared to be.

After she was done, she let me change into my clothes and I was asked to wait in a different waiting room. Another cold and ‘clinical’ looking room. Plastic chairs and generic looking walls that don’t speak to anyone. It screamed of people being really sick. They called me back in to get ultrasound done. When they did the ultrasound they confirmed that my lump was a cyst. It was 13 centimeters long going from the left side of my breast, where I felt it, into the back of my breast. I couldn’t believe how big it was! The doctor told me that it was no big deal that as women get older it happens and is more common. The technician working with him asked me if I wanted her to drain it and I said yes. She did it while I watched the screen and watched it disappear. It was really weird. The technician then asked me if I wanted to see what came out. That made me nauseous. I told her ‘Not unless you want me to vomit on you!’ It didn’t help that she said, ‘It’s only green stuff.’ Yeah, that did it for me, a wee bit of vomit! I definitely did not need to hear that!

I asked the doctor what causes these cysts and how could I prevent them. He said, ‘there’s nothing you can do about them, it just happens as you get older.’ I told him ‘I will Google it then, and find the answers.’ He didn’t seem to worried and really didn’t seem to be bothered about finding out this information himself. A shame really because there are loads of resources when you look for this stuff. I found a UK Surgeon who writes quite a few articles about different breast health issues and he has written about non-malignant lumps. I thought it would be a good idea to pass this information on. I am always finding cysts now and actually go through the same thing over again when I do find a lump. I think it would be helpful for everyone to have this information so there is no surprise if you get this diagnosis.

I have had some considerable results with my clients when we work on educating ourselves with all the information needed. I am a firm believer in knowing what it is we are dealing with. If you arm yourself with education you will find you are more confident in what will happen next. There are no surprises. I’ll enclose the link to Professor Kefali Mokbel’s article on breast cysts. Enjoy the information and as always, feel free to comment, share and like this post.

Have a sparkly day!

http://www.totalhealth.co.uk/clinical-experts/professor-kefah-mokbel/understanding-breast-cysts