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Mastectomy and Breast Reconstruction Combined

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By DR. STEPHEN COLEN New York University Medical Center For AP Special Features There has been a marked increase in recent years in the number of women who have reconstructive surgery immediately following a mastectomy. In the 1980s, about 10 percent of women who had a mastectomy had immediate breast reconstruction. Today, that figure is about 50 percent among the 50,000 women a year who undergo mastectomy. One benefit is psychological. The patient wakes up after surgery and has not lost a breast. There are major physical benefits as well. The surgeon who removes the breast can do a skin-sparing mastectomy, removing less skin than usual. Also, immediate reconstruction does not interfere with chemotherapy and radiation therapy, if necessary. And the woman who chooses immediate reconstruction is spared the cost and inconvenience of being hospitalized a second time. Medical insurance is more likely to pay for reconstructive surgery when it is done in conjunction with the mastectomy. A growing number of medical institutions offer immediate reconstructive surgery for mastectomy. Some states, such as New York, require that it be offered to every woman undergoing mastectomy. Information about hospitals that perform immediate breast reconstruction can be obtained from women's groups such as Reach for Recovery. The breast to be reconstructed can be made from a woman's own tissue, most often taken from the abdomen, or from an artificial implant. Often, the decision is based on the size of the breast to be replaced and the patient's preference. Silicone implants, whose safety has been questioned, are no longer used. They have been replaced by saline-filled implants, which are both safe and effective. --- Dr. Stephen Colen is Associate Professor of Surgery at New York University School of Medicine. Copyright 1996 Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.