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.
Gynaecomastia
Description of the problem
Gynaecomastia is a condition that occurs in men, in which excess breast tissue forms behind the nipple. The volume may increase to such an extent that it may resemble a female breast and it can affect just one or both sides. This problem is essentially cosmetic, but can be very psychologically disturbing for the patient. There is however, no increase in the risk of developing cancer just because the breast tissue is larger.
The condition is quite common, affecting up to a third of the male population to some extent. The cause in the majority of cases is unknown. It happens because of sensitivity of the breast tissue to the hormones which circulate during puberty. An imbalance between male and female hormones occurs during puberty and also as testosterone levels dwindle in later life. Specific causes for gynaecomastia include congenital abnormalities, hormone-secreting tumours and some medications.
There is an important distinction in gynaecomastia between ‘true’ where the breast gland itself has caused the enlargement and pseudo-gynaecomastia where there is a general increase of fatty tissue in the area leading to the appearance of breasts. These two forms often combine.
The disease can appear as a slight bulge in the nipple region or go on to develop a fully formed breast. The condition can often resolve by itself, particularly where the underlying cause can be treated. If, however, the appearance persists, a plastic surgeon can help to remove the excess tissue.
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| Front view | Side left |
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| Side right | |
Purpose of the procedure
If all underlying causes have been ruled out or treated and the disease has persisted for over a year, it is appropriate to proceed with surgical intervention. The goal of surgery is to remove the glandular tissu , excess fat and leave only a small scar under the nipple.
Surgical Technique
Fat and some of the glandular tissue can be removed by liposuction, but if residual glandular tissue still needs to be removed, this is done through a small scar along the lower edge of the nipple. After the gland has been removed, the excess skin can often be left to contract by itself, though it may initially appear wrinkled at first. Sometimes excess skin may also need to be removed. The tissue is sent to the pathologist to check for any abnormalities.
Figure: (above) Mixed type of gynaecomastia. (below) Partial gland resection combined with liposuction generates good results.
What to expect after surgery
Sometimes a drainage tube must be left underneath the skin. This usually stays in for 1-3 days. Tight elastic bandage is used to compress the area after surgery. Some normal occurrences after the surgery include:
- Bruising: especially after more extensive surgery
- Temporary loss of sensation (chest and nipple)
- Swelling
- Mild pain and discomfort: The pressure bandage often worsens this, but it is an essential part of the postoperative care.
- Restricted movement: partly caused by the bandage and partly by discomfort
Length of Stay
Mild forms can be treated as day cases, others may need to stay for 1-3 days
What can you expect after the surgery?
The elastic bandage needs to stay on for about 10 days. If the wound has been sealed with glue, the area can be showered after 3 days and the elastic bandage replaced. You are advised to restrict vigorous arm movements over the first 3 weeks. Hard work and sports are not advisable for the first 4 weeks. How long you feel uncomfortable for afterwards depends on the extent of the disease and your surgery.
Possible Complications
Local:
- Bleeding
- Infection
- Wound healing problems
- Skin irritation
- Late complications
- Permanent sensory changes
- Asymmetry
- Nipple flattening
