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.

Breast Cancer THErapies and Treatments

ADJUNCT THERAPIES
Therapy and treatment options are based upon the type of breast cancer, its stage and whether the cancer cells are sensitive to hormones, your overall health is factored in and of course – your personal preferences. Most women undergo breast surgery for breast cancer – and must receive additional (adjunct) treatment such as chemotherapy, radiation or hormone therapy.  Decision making is often complex and overwhelming due to there being so many options. Dr. Davison works closely with your oncologist to guide you compassionately through the entire process.  Although your oncologist determines what adjunct therapy is needed this determination serves as a guide for breast reconstruction.

Breast cancer Map

TREATMENTS & DRUGS
Treatments include several surgical procedures as well as drugs to treat the breast cancer.  There are several options – and each option is suitable for different types and stages of breast cancer.  The appropriate treatment is determined after careful examination and diagnostic testing.  Treatments include:

Lumpectomy
This involves removing the tumor and a small margin surrounding healthy tissue. Lumpectomy is typically reserved for removal of smaller tumors that are easily separated from the surrounding tissue.

Mastectomy
Mastectomy may be simple -meaning all the breast tissue – the lobules, ducts, fatty tissue and skin including the nipple and areola are removed.  Mastectomy can also be radical – meaning the underlying muscle of the chest wall is removed along with surrounding lymph nodes in the armpit.

Sentinel Node Biopsy – This means removal of one lymph node. Since breast cancer that spreads to the lymph nodes may also spread to other areas of the body – the lymph node near the breast tumor, which receives the lymph drainage from the cancer, is removed and tested for cancer.  If no cancer is found, the chance of finding cancer in any of the remaining nodes is small – and no other nodes need to be removed.

Axillary Lymph Node Dissection
If cancer is found in the sentinel node, then additional lymph nodes in the armpit are removed.  Determining if cancer has spread to the lymph nodes helps choose the best course of treatment – including whether or not chemotherapy or radiation is needed.

Radiation Therapy
Radiation therapy uses high powered beams of energy – similar to X-rays – to kill cancer cells.  This can be done outside the body or by placing radioactive material inside your body (brachytherapy).

Chemotherapy drugs
These are used to destroy cancer cells.  If you are at high risk for cancer returning or spreading to another part of the body – chemotherapy may be recommended after surgery to reduce the chance of the cancer recurring.  This is called adjuvant systematic chemotherapy.  Chemotherapy is sometimes given to women with larger breast tumors with to goal of “shrinking” the tumor size to make it easier for surgical removal – and increasing the chance of a cure. This is called neoadjuvant chemotherapy.

Hormone Therapy
Also referred to as hormone blocking therapy and is often used to treat breast cancers that are sensitive to hormones. These are referred to as estrogen and progesterone receptor positive cancers. These medications includeTamoxifen, Arimidex, Femara and Aromasin. These drugs work by either blocking estrogen or the enzyme that converts androgens to estrogen. The latter are effective in menopausal women only.

Targeted Drugs
Targeted drugs attack specific abnormalities within cancer cells and there are several that are approved for this purpose.

UNILATERAL –vs – BILATERAL TREATMENT
After a unilateral mastectomy women are faced with still more decisions to make about the remaining breast.  If reconstructive breast surgery is performed to rebuild the diseased breast after a mastectomy - this typically causes a symmetry problem with the unaffected breast.  The reconstructed breast is usually greater in volume and size with a different shape than the un-operated breast.  Clearly proportion – balance – symmetry and a natural look are gone. There is also concern about possibility of cancer developing in the other breast.  Many women today opt for prophylactic mastectomy of the other breast in order to avoid that risk.  Reconstruction can be done – symmetry achieved – and risk eliminated.

IMPLANTS OR FLAPS?
Another topic that must be discussed during the consultation is whether or not a patient who can – would want to use implants to help rebuild their after mastectomy.  Or are they adverse to having a foreign object in their body. It is important for Dr. Davison to know exactly how feel in order to tailor your treatment plan so it will work – and you will be happy with the outcome.  During your consultation he will determine which method would work best for you – you must then choose.

FLAPS & BODY TYPES
Lifestyle and body habitus (thin vs fat body) helps determine the type of body flap that can be used for an individual’s breast reconstruction.  Today’s flap reconstruction procedures can achieve wonderful outcomes - using  a woman’s own living muscle and tissue - to rebuild a natural looking breast mound.  The type of flap procedure is determined by the individual’s personal factors.

 

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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.