Most breast cancer survivors, especially women, often choose to undergo a breast reconstruction after surgery, which of course depends on a lot of things. As you may know, breast cancer remains the leading cause of cancer-related mortality in the world. And as we mark Breast Cancer Awareness Month this October, I had the opportunity to catch up with Dr. Adnan Tahir, a Consultant Plastic, and Reconstruction Surgeon based in Dubai, who agreed to share with us some psychological aspects in relation to breast cancer and breast reconstruction following mastectomy.
Breast Cancer and Reconstruction
According to the World Health Organization (WHO), breast cancer is the leading cause of cancer-related deaths in women and accounts for over half a million deaths worldwide. Although there are multiple risk factors involved in developing breast cancer treatment, the standard treatment worldwide remains early diagnosis and awareness, followed by a surgical procedure of removing the entire breast (Mastectomy) or part of the breast (Wide excision). This is usually combined with a procedure to either sample or remove lymph glands in the armpit. Depending on the severity of the cancer, subsequent radiotherapy or chemotherapy is also needed.
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Patient Anxiety
“The psychological and personal impact of breast cancer is tremendous and cannot be underestimated. Loss of confidence, low self-esteem, depression, are common in individuals who have the above surgery and it is a reason for the breakdown of relationships,” explains Dr. Adnan. Furthermore, fear of surgery and complex treatments on offer can often add to the patient’s anxiety.
Breast reconstruction, he says, aims to address these issues by creating a breast in order to restore volume and symmetry with the other breast where necessary. This requires a procedure involving either transplanting one’s own tissue usually from the abdomen (DIEAP flap) or occasionally from other areas such as the buttocks, thighs, or back.
Breast Prosthesis
Another commonly used option is the use of breast prosthesis after a period of tissue expansion using a tissue expander under the mastectomy scar. The choice of the procedure varies per patient depending on the original cancer treatment, availability of tissue for flaps, and the fitness of patients to have these operations. Usually, this is decided in conjunction with a breast team comprising a breast surgeon, Plastic surgeon, and breast care nurses who educate the patient on the various methods.
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Breast Reconstruction and Psychological Well-being
There are numerous studies available that have highlighted the benefits of breast reconstruction in improving the psychological and physical well-being of an individual who has gone through breast cancer treatment and breast reconstruction. “This is considered as a journey that one has to make with their surgical team in order to restore the well-being of the patient as it was before the diagnosis of breast cancer was made,” states Dr. Adnan, adding that this is surgically possible. “Improvements in quality of life, anxiety, depression and overall body image are some of the important benefits of breast reconstruction.”
The Earlier the Better
Due to current techniques available, it is important to involve the patient early in the decision-making process regarding their treatment in order to limit the psychosocial impact of breast cancer on their lives, advises the Doctor.
“Although severe depression is rarely seen nowadays, treatment anxiety, fear of disease recurrence, changes in body image and sexuality remain genuine concerns. These have to be addressed early on after the diagnosis of breast cancer by patient education, ideally by breast care nurses familiar with these issues and who form a part of the multi-disciplinary breast team that deals with breast cancer.”
Equally, it is very important for all professionals treating breast cancer including doctors and nurses to identify and address these issues in patients and treat each case individually as the psychological needs vary tremendously.
Breast Cancer Awareness
Finally, awareness of breast cancer says Dr. Adnan, is the key to preventing deaths from this deadly disease by early diagnosis and treatment. Due to cultural and social complexities and taboos, we as a society have a long way to go in this regard and make every possible effort to educate women (and men) about breast cancer.
xoxo
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