Delayed Breast Reconstruction

When a woman is first diagnosed with breast cancer, her only concern is beating it and getting better. It is a frightening and overwhelming time. Once she has a mastectomy to remove the breast(s) and feels more confident about her survival, thoughts may turn to preserving her femininity. Women who decide to have reconstructive surgery need to consider whether to have it at the same time as the mastectomy or to delay it. Neither option is right or wrong. It is only a matter of what works best for each individual woman and what her surgeon recommends.

The surgeon will have a good idea of the extent of the patient’s breast cancer based on the results of her biopsy, mammograms and other imaging modalities. However, it is impossible to know the full impact of the cancer until after the mastectomy has been completed. The surgeon will also evaluate the patient’s lymph nodes before surgery. Some patients with more advance cancer may have a mass felt in her axilla or those lymph nodes may look prominent on her preoperative imagery. For these advanced cancers a delayed approach may be the best option. Also other body shapes may be better treated with a delayed reconstruction.

Other Pros and Cons to Consider

One advantage of delaying breast reconstruction is that it gives patients the chance to just focus on treatment. It also provides time to research the various reconstructive options available. The obvious downside is living without breasts in the interim. If this is a major concern, patients should ask about the possibility of receiving temporary prosthetics.

While immediate reconstruction can lessen the emotional impact of a mastectomy, it is not without risks. The biggest one is that the woman may need radiation later and this is likely to damage the new breasts. Immediate reconstruction also requires a longer surgery and recovery period. Even when a patient opts for immediate reconstruction, it may require several surgical procedures to achieve the desired results.