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.

Breast Conserving Surgery - Tissues Flank

Occasionally, redundant tissue is present close to the breast, on the flank. This tissue, consisting of the skin and underlying fat, is supplied by blood vessels called intercostal perforators (Fig.1). Similar to to the ThoracoDorsal Artery Perforator (TDAP) flap, an elliptical skin island can be harvested on these small vessels, known as the Lateral Intercostal Artery Perforator (LICAP) flap. This tissue can then be rotated into an adjacent breast defect, using its vessels as a pivot point, without the need for microsurgery.

The LICAP flap leaves a horizontal scar on the flank and back. This scar can be completely hidden underneath the bra and arm and is often inconspicuous. The LICAP flap has similar advantages and disadvantages to the TDAP flap. However, only patients with tissue available on their flanks are going to be suitable for this technique and only minor defects on the lower, lateral part of the breast can be filled.

Fig. 1: The LICAP flap: the lateral intercostal perforators lie on a line in the axilla (red crosses). Based on one or two of these vessels, an island of skin and fat from the flank and/or back can be raised. The flap is then rotated through 180 °, pivoting on these arteries, to reach the breast defect.


Fig. 2a	Fig. 2b	Fig. 2c

Fig. 2: (a) Pre-operative picture of a right breast with a depression and lack of volume. (b,c) Post-operative picture after transferring the LICAP flap from the right flank. The shape and volume of the breast are restored, leaving a horizontal scar within the bra-line.