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A Little Advice – Breast Cancer
By: Lars P. Enevoldsen, M.D., Plastic Surgery
Modesto - October 1, 2011
As a Central Valley plastic surgeon I am sometimes called on to perform breast reconstruction after a mastectomy. Over the past 20 years I have performed many breast reconstructive procedures. Based on my experience, I would give you the following advice:
First of all, no one will know your breasts better than you. That is why it is so important to be in the habit of performing a self breast exam every month. You need to learn exactly what your breasts feel like and if you notice any changes like a lump that wasn’t there before, make sure to have it checked by your doctor. In addition to self exams, you need to have routine mammograms done as is suggested by your doctor.
Secondly, if you do notice any changes that concern you, make sure that your doctor shares your concern and doesn’t tell you something like, “Don’t worry, it’s probably nothing.” Although most of the time there is nothing to worry about, sometimes there is. I will never forget one of my patients who was told for two years by her doctor that her lump was nothing and he/she ordered no studies to investigate it until my patient developed two lumps in her armpit. By the time the lumps developed in her armpit it was basically too late. During her mastectomy it was obvious that the cancer had spread and her life expectancy was much shorter than it would have been had something been done two years earlier. If you are concerned about a finding on your breast exam and you don’t feel that your doctor is doing what needs to be done, then make an appointment with a general surgeon and have it evaluated by someone who deals with breast cancer on a regular basis.
That brings me to my third point. Most often, breast cancer is not an emergency. You don’t need to be rushed into the operating room for a procedure immediately. Take time to consider all of your options. What that means is that you should be given a chance to meet with a plastic surgeon to find out what your choices are for reconstruction if a mastectomy is recommended. In some cases it may be appropriate to perform an immediate reconstruction at the time of the mastectomy. If that is the case then you will have to decide which technique is best for you with the help of your plastic surgeon. It is also advisable to meet with a plastic surgeon even if only a lumpectomy is recommended. The reason for this is that your surgeon is not doing you any favors if “breast conserving” surgery is performed and followed up with radiation therapy if you end up with a deformed breast that will be much more difficult to reconstruct because of the radiation exposure. In terms of an aesthetically pleasing reconstructive outcome you may in fact be better off with a mastectomy, no radiation, and an immediate breast reconstruction.
I hope that the only advice you ever need to follow will be to do your monthly breast exams and routine mammograms and that you will never have to use the rest.
