From Mastectomies To Breast Reconstruction

In this episode of Health & Living, BFM Producer, Lim Sue Ann, speaks to SJMC Consultant Breast Surgeon (Oncoplastic) Dr Teh Mei Sze and breast cancer survivor Madam Wong.

While mastectomy can be life-saving, it may affect a woman's self-esteem and body image. In conjunction with Pink October, learn about breast reconstruction from both surgeon and patient perspectives. 

"A mastectomy involves the removal of the entire breast, usually done for breast cancer, and can vary in types, such as standard mastectomy, nipple-sparing mastectomy, and skin-sparing mastectomy. A lumpectomy, on the other hand, is a partial removal of breast tissue, preserving the breast as much as possible," Dr Teh explained. 

There are various factors influencing the choice between mastectomy and lumpectomy. One most important point is disease factor. If the disease is diagnosed early and presents in only one location, then a lumpectomy is considered. However, when the disease is diagnosed late and is locally advanced, or present in multiple areas of the breast, these are not suitable for lumpectomy. If a patient undergoes a lumpectomy with radiotherapy during or after surgery, the risk of local recurrence is high compared to mastectomy.

"But if the patient undergoes both a lumpectomy and radiotherapy, the risk of local recurrence is almost similar as a mastectomy. The type of mastectomy depends on the patient's desire whether they want a breast reconstruction or not," Dr Teh said. 

She added that when talking about preventive mastectomy, or in medical terms, prophylactic mastectomy. This is performed before being diagnosed with breast cancer and is commonly performed on those who have hereditary breast cancer genes, such as the BRCA1 or BRCA2. These patients are recommended for a mastectomy is because they have more than 30 times the chances of getting breast cancer. 

Meanwhile, Madam Wong shares her personal journey from diagnosis to lumpectomy, emphasising the importance of early detection and timely treatment. She highlights the emotional and physical aspects of dealing with breast cancer, including her pragmatic approach to body image.

Dr Teh shares that in breast reconstruction surgery, there are options such as silicone implants or autologous flaps, where tissue is taken from other body parts to create a new breast contour. She emphasised that breast reconstruction should be considered a crucial part of breast cancer treatment rather than just a cosmetic enhancement. 

"Many will have lack of self esteem and dress differently after surgery, but they do not have to suffer. With the correct treatment and disease management, they could go back to their usual lifestyle," Dr Teh said. 

Usually mastectomies and breast reconstructions are not done by the same surgeon. A breast surgeon comes in to do the mastectomy and then later a plastic surgeon to do breast reconstruction. Dr Teh is a breast oncoplastic surgeon where she is trained in breast surgery and breast reconstruction, allowing her to perform both. 

Mammogram is the gold standard for breast cancer screening. If you have a strong family history with breast cancer, start early screening at 40 years old and then do it every one to two years until you're 74.

Source: BFM