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Breast Cancer Detection after Reconstruction
This post addresses three common questions my patients have following breast cancer reconstruction:
- Will breast reconstruction hide other tumors that may later appear in the breast tissue?
- Will breast reconstruction encourage the growth of new cancerous cells?
- Should I continue with regular mammograms and breast self-exams?
Does breast reconstruction hide subsequent tumors?
During a mammogram, implants can occasionally interfere with obtaining a good picture, so your technologist must be trained at positioning the implant to enable the best possible image. In a flap reconstruction, the mammogram image may reveal surgical clips or scars, or the breasts might appear fatty, but an experienced technologist will be able to detect any abnormality. Breast reconstruction rarely, if ever, hides a return of breast cancer, so you shouldn’t consider this a significant risk when deciding to have breast reconstruction after mastectomy.
Will breast reconstruction encourage the growth of new cancerous cells?
No research has shown that reconstruction, either with implants or tissue flaps, increases the risk of the breast cancer returning or of a new cancer forming.
What about mammograms and breast self-exams?
After your reconstruction, whether it involves implants or tissue flap reconstructions, it is important to have regular mammograms at an experienced facility. I also encourage you to keep performing breast self-examination on both breasts as soon as you are fully healed from your surgery. This will enable you to notice and report any changes you feel. You should expect your reconstructed breast to feel different, and your doctor or nurse can help you understand the changes.
Many women have misconceptions about breast reconstruction. Many doctors share and plant these ideas. If a woman wants to feel whole, and is healthy enough to undergo a mastectomy, then she most likely is healthy enough to have a reconstruction. If the fear is that detection of breast cancer is impossible, then that fear should be put to rest.
when one has this procedure does one continue with mammograms for the tram reconstructed breast as usual?
what are restrictions in regards to exercise as above and are there limits for weight when lifting?
When one has a DIEP FLAP or tram flap breast reconstruction, the breast consists of abdominal fat and not breast tissue. With a DIEP FLAP breast reconstruction the breast will look, feel, and jiggle like a breast, but it is not a breast. It is abdominal fat. Therefore, mammogram examination is unnecessary. In patients who I have performed DIEP FLAP breast reconstruction the only restriction I impose is no lifting of more than 10 pounds or straining the abdominal muscles for the first six weeks after the surgery. After that time, all normal activity and exercise can be resumed. With tram flap breast reconstruction, one of the main abdominal wall muscles has been removed. This will permanently weaken the abdomen and will leave you at greater risk for hernia formation. The exact restrictions with this kind of surgery are up to the surgeon involved.