Breast Reconstruction Surgery

Davinci plastic surgery | Washington dc | steven p. davison, md

BREAST RECONSTRUCTION CAN BE dONE WITH DIFFERENT TYPES Of FLAPS OR IMPLANTS. Dr. DAVISON ALSO DOES RECONSTRUCTION FOR PATIENTS THAT ARE BRCA POSITIVE.

BREAST RECONSTRUCTION CAN BE dONE WITH DIFFERENT TYPES Of FLAPS OR IMPLANTS. Dr. DAVISON ALSO DOES RECONSTRUCTION FOR PATIENTS THAT ARE BRCA POSITIVE.

BRCA - GENETIC PREDISPOSITION & BREAST CANCER

Certain women are genetically predisposed to getting breast cancer.  Testing is simple – it involves a simple blood test…

BRCA genetic testing is a simple blood test to determine if a woman – who has a strong family history of breast and/or ovarian cancers – is at risk for developing cancer herself.  The test does not show if cancer is present or not – it determines the level of risk factor based upon gene mutations – in genes that help control normal cell growth. About 5% to 10% of all breast and ovarian cancers are linked to BRCA1 and BRCA2 gene changes.  If a woman tests positive for one of these changes – the lifetime risk for breast cancer can be as high as 85% and up to 60% for ovarian cancer. These numbers show a wide range of chance and depend upon other personal and family history.  While breast cancer is extremely rare in men – it does occur and is related to BRCA2 gene changes along with a possibility of prostate cancer. Risk of some other cancers such as pancreatic and colon cancer may also be higher.  The genes can be inherited from either the mother’s or father’s side of the family.

Certain people are at higher risk for inheriting BRCA1 and BRCA2 gene changes. They include:

  • Jewish Women – in particular Ashkenazi Jews (ancestors originate in Eastern Europe) – are at risk if they have one or both of the following: 
    • Any first-degree relative with breast or ovarian cancer – including parents, sisters, brothers and children.
    • Two second-degree relatives – on the same side of the family – with breast or ovarian cancer.  These include aunts, uncles, nieces, nephews and grandparents.
  • Non-Jewish people – recommended for gene testing if they have 1 or more of the following:
    • Two first-degree relatives with breast cancer – 1 of whom was diagnosed before age 50
    • Three or more first or second-degree relatives with breast cancer – any age
    • Both breast or ovarian cancer in the family
    • A first degree relative with cancer in both breasts
    • Two or more relatives with ovarian cancer
    • One relative with both breast  and ovarian cancer
    • A male relative with breast cancer

Genetic counseling before and after gene testing is very important to help with understanding the benefits, risks and possible outcomes of the test. The strong recommendation for women who carry this gene is to have prophylactic mastectomy and bilateral breast reconstruction.  It is also common for women to have her ovaries removed, to eliminate that risk and fear.

PROPHYLACTIC MASTECTOMY

Definition: Prophylactic preventative mastectomy is the surgical procedure performed to remove one or both breasts to prevent or reduce the risk of developing breast cancer. 

Women who are at high risk of developing breast cancer often consider and decide to reduce their risks by undergoing prophylactic – or risk reducing mastectomy as it is also called.  In a total mastectomy the surgeon removes the entire breast and nipples.  In a subcutaneous mastectomy, the breast tissue is removed but the nipple is left intact. An in depth discussion with your breast surgeon - of what is right for you - is important.

WHY WOMEN CHOOSE PREVENTIVE MASTECTOMY SURGERY

  • Previous breast cancer – if a woman has had breast cancer in one breast, the risk of developing it in the other breast is greater.
  • Family History of breast cancer- risk of developing breast cancer is greater for women with a mother, sister or daughter who have had breast or ovarian cancer.
  • Breast cancer-causing gene alteration – a woman who tests positive for changes, or mutations, in certain genes that increase the risk of breast cancer such as BRCA1 or BRCA2 gene often consider prophylactic mastectomy.
  • Lobular carcinoma in situ- this condition increases the risk of developing breast cancer in either breast.
  • Radiation therapy – women who have been treated for Hodgkin’s lymphoma are included in this group - among women who have had radiation therapy to the chest before age 30.  These women are at increased risk for developing breast cancer throughout life.

View before and after photos

All in the Family: BRCA Positive

Dr. Davison's medical assistant tested BRCA positive and more than a year ago had preventative breast reconstruction surgery. Watch this video to learn more about the Davis Family Legacy and history of cancer.

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Steven P. Davison, MD

Steven P Davison - board certified plastic surgeon

Breast Reconstruction
Plastic Surgeon
Washington, DC and Northern Virginia

Dr. Davison is board certified and fellowship trained with a special interest in breast cancer reconstruction.  His unique and desirable skillset places him in a special league of surgeons who can provide unequaled expertise in full-spectrum plastic and reconstructive surgery.  He is able to effectively deal with other cancers as well, including melanoma and successfully manages many  surgeries of the body, both cosmetic and reconstructive.  Dr. Davison’s interest in breast and body contouring facilitates in his creation of a natural, aesthetic breast that is pleasing to the patient and grants him hundreds of happy patients.