You’ve made it through many of the hard choices in your breast cancer treatment only to confront another major one: whether — and when — to have your breast (or breasts) reconstructed after your mastectomy. Some women want a fully reconstructed breast that looks as much as possible like the original. Others want a new breast that simply helps them look the way they like in a bathing suit. Still, other women have no desire for breast reconstruction at all.
In recent years, the number of women choosing breast reconstruction appears to be on the rise. In 2015 106,000 reconstructive procedures were performed, a 35 percent increase since 2000, according to the American Society of Plastic Surgeons. About 63 percent of women chose to have it, according to the association, and in some parts of the United States, about 80 percent of women asked for breast reconstruction after a mastectomy. One fairly new practice — called oncoplasty — combines breast cancer surgery with reconstruction during the same operation. However, studies find that breast reconstructive surgery is still underutilized.
You can have the reconstruction done at the time of the mastectomy, or you can wait until any additional treatment for your breast cancer, such as chemotherapy or radiation, has been completed. A 2010 study found that women who need radiation after a mastectomy may be better off waiting for reconstructive surgery. Among those who needed radiation, complications occurred in 44 percent of those who had immediate reconstruction, but only in 7 percent of those who did not have immediate reconstruction. Chemotherapy did not appear to impact complication rates.
Immediate reconstruction means a longer initial operation, but it spares you the distress of living for a time without a breast. On the other hand, delaying the reconstruction enables you to deal with your cancer and its treatment without the added burden of having to make more decisions right away. Depending on your medical condition, you and your doctor may decide that a lengthy initial surgery would put undue stress on your body.
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