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.
DIEAP - Cases
Unilateral delayed breast reconstruction
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| Fig. 1a | Fig. 1b |
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| Fig. 1c | Fig. 1d |
Fig. 1: Pre-operative (a) and post-operative (b, c, d)pictures of a patient who underwent delayed reconstruction of the left breast using a DIEAP flap, nipple reconstruction and tattooing.
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| Fig. 2a | Fig. 2b |
Fig. 2: Pre-operative (a) and post-operative (b) pictures of a patient who underwent delayed reconstruction of the left breast using a DIEAP flap, nipple reconstruction and tattooing.
Unilateral immediate breast reconstruction
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Fig. 3a |
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Fig. 3b |
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Fig. 3c |
Fig. 3:
(a) Pre-operative pictures of a patient with a malignant tumor in the left breast. The position of the tumor is marked by blue dye (a technique no longer used today).
(b) Post-operative pictures of the same patient 2 years after undergoing a left-sided skin-sparing mastectomy, immediate reconstruction of the left breast using a DIEAP flap, full breast adjuvant radiotherapy and in a later phase, nipple reconstruction and tattooing. The increased pigmentation of the skin is due to the radiotherapy.
(c) Post-operative pictures of the same patient 4 years postoperatively. The radiation stigmata like discoloration of the skin and fibrosis (stiffening) of the breast have subsided.
Bilateral Immediate breast reconstruction
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| Fig. 4a | Fig. 4b |
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| Fig. 4c | Fig. 4d |
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| Fig. 4e | Fig. 4f |
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Fig. 4: Pre-operative (a) and post-operative pictures (b, c) of an immediate reconstruction of both breasts using bilateral DIEAP flaps, after an areola-sparing mastectomy of the right breast and a skin-sparing mastectomy of the left breast (performed because the tumour was close to the nipple). (c) The right areola with a small skin island from the flap that can be subsequently used for nipple reconstruction. (d) After nipple reconstruction and tattooing of both areolas. (e, f, g) 3 years after the initial surgery, the scars have faded considerably.
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| Fig. 5a | Fig. 5b |
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| Fig. 5c | Fig. 5d |
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| Fig. 5e | Fig. 5f |
Fig. 5: (a) A 43 yrs. old woman diagnosed with a BRCA-2 mutation presents for bilateral areola-sparing mastectomy and autologous reconstruction. (b) In a first operation a primary breast reconstruction is performed with a free ipsilateral SGAP flap. (c) Intermediate situation after reconstruction of the right breast with a free DIEAP flap. Note that the additional skin island of the DIEAP and SGAP cause supplementary drooping of both breasts. Also, the left breast has a typical appearance after primary shaping of an SGAP flap: important hollowing of both upper quadrants and a visible upper ridge of the flap. (d, e, f) 1 year post-operative result after the fourth procedure, involving bilateral nipple reconstruction, liposuction of the upper ridge of the SGAP flap and lipofilling of both upper quadrants.
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Fig. 6a |
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Fig. 6b |
Fig. 6: Pre-operative (a) and post-operative pictures (b) of an immediate reconstruction of both breasts using bilateral DIEAP flaps, after an areola-sparing mastectomy of both breasts. Nipple reconstruction and tattoo were done in a separate surgical procedure.
Mixed delayed and immediate bilateral breast reconstruction
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| Fig. 7a | Fig. 7b |
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| Fig. 7c | Fig. 7d |
Fig. 7: Pre-operative (a) and post-operative pictures (b, c, d) of an immediate reconstruction of the right breast with an SGAP flap and a delayed reconstruction of the left breast using a DIEAP flap. The DIEAP flap was chosen for the left breast as a large amount of skin was needed to recreate a normal drooping shape of the breast. The SGAP flap was chosen because the abdominal flap did not contain sufficient volume to recreate both breasts. Nipple reconstruction and tattoo were done in a separate surgical procedure.
Bilateral delayed breast reconstruction
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| Fig. 8a | Fig. 8b |
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| Fig. 8c | Fig. 8d |
Fig. 8: (a) status after repeated attempts at breast reconstruction with implants. The right breast was irradiated. Infection of the right prosthesis led to removal. On the left side the implant is still in place, but the shape is distorted by displacement and strong capsular contracture. (b) Situation after removal of the implants, removal of the scarred tissue caused by radiation, bilateral breast reconstruction with free DIEAP flaps, nipple reconstruction and tattooing of the areolas.
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| Fig. 9a | Fig. 9b |
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| Fig. 9c | Fig. 9d |