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.
Complications Implants
Complications implants
Early complications
Placing a breast implant is a relatively simple procedure, associated with very few initial complications.
However, following any surgical procedure there is always the possibility of bleeding, infection, delayed wound healing, deep vein thrombosis and more rarely pulmonary embolism. Implants have a slightly increased risk of infection, as they are made of foreign material. Fluid collections around the implant, called seromas, may also be detected following surgery.
Late complications
Capsular contracture is the most common late complication following breast implant surgery.
A capsule is a layer of scar tissue that develops around an implant. It is produced naturally by your body in response to the presence of a foreign object. Initially, the capsule is thin and pliable and the implant feels soft (fig. 1). Later on, the capsule may start to thicken and the implant can progressively harden (fig. 2).
The capsule may continue to tighten and compress the implant (fig.3), which is known as capsular contracture. This distorts the shape of the implant and causes pain (fig. 4). The exact cause of capsular contracture is unknown.
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| Fig. 1 | Fig. 2 | Fig. 3 | Fig. 4 | Fig. 5 |
Capsular contracture can occur at any stage following surgery, although it is more common in implants that have been in place for a long period of time. The risk of capsular contracture rises to 70% after radiotherapy.
When the contracture is so severe that it deforms the breast (Baker classification IV) (fig. 5), it can be treated by either releasing the capsule (capsulotomy) or by completely removing it (capsulectomy). In some cases, the implant may also have to be exchanged.
Other late complications include displacement of the implant, the presence of palpable implant edges, chronic pain or wrinkling of the overlying skin.
Implants can move if they have been poorly positioned at the time of surgery or with contraction of the pectoralis major muscle (fig. 6). Rippling occurs when the overlying tissue is thin and the implant surface becomes visible (fig. 7).
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| Fig. 6 | Fig. 7 |
If the overlying skin is very thin, friction from the implant may cause it to perforate (fig. 8). In addition, the implants themselves can rupture but they usually last an average of 8 to 10 years before they need to be exchanged.
Fig. 8
Breast implants do not cause a higher incidence of breast cancer recurrence, other malignant diseases, auto-immune diseases, dermatological problems or degenerative diseases.
In our experience and according to the medical literature, radiotherapy to the breast, before or after placing an implant, leads to an increased incidence of these complications. In addition, complications present earlier after radiotherapy. Since the effects of radiotherapy can last up to 15-20 years, many reconstructive centres no longer use implants in combination with this treatment.
Finally, patients must understand that it is frequently impossible to achieve the superior, stable, long term aesthetic results with implants that can be achieved with autologous breast reconstruction.
Breast Reconstruction with Expanders and Implants
Read about breast reconstruction guidelines with implants in the following documents. These reports have been put together by a special guideline committee of the American Society of Plastic Surgeons (ASPS), using only data from sources and publications with a high degree of evidence based medicine (EBM). Breast reconstruction guidelines for autologous tissue will be available by the end of 2014.
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