When breast conservation is not an option or when a woman chooses mastectomy for treatment of breast cancer, immediate breast reconstruction helps them restore their body and their psychological peace of mind.

Today there are many different options for reconstruction including an implant filled with either saline or silicone gel or tissue transferred from the back, belly or buttocks (with or without added implants). In a latissimus dorsi flap reconstruction, tissue, including skin, fat and muscle, is taken from the back and tunneled to create a breast mound to reconstruct the breast. A tissue expander, an inflatable implant, is placed underneath the chest muscles. The expander is inflated to maintain the new breast’s shape until a permanent implant – a silicone or saline filled implant – can be put in.

Patients may be in the hospital for two to four days after surgery, and it may take three to four weeks to heal completely.

Three months following the implant procedure, another procedure is performed to recreate the breast’s nipple and areola. The surgeon reconstructs the nipple and areola with tissue form the reconstructed breast. Tattooing is added to complete the nipple and areola reconstruction.

Not every patient is a good candidate for breast reconstruction using back tissue; it depends, for one thing, on the amount of tissue required to recreate the breast.   

Prior to seeing the reconstruction procedure, webcast viewers will see patients undergoing procedures including:

• Stereotactic Core Biopsy – A biopsy is the removal of a piece of tissue for examination under a microscope. A stereotactic core biopsy is an outpatient, non-surgical procedure performed by a radiologist using a needle and mammography. In this procedure, the patient lies face down on a specially designed table with a hole in the center through which her breast extends downward. A revolving mammography unit attached to the underside of the table obtains images of the breast from several angles. The information is relayed almost instantly to the computer, which pinpoints the location of the abnormality. After this a local anesthetic is administered. Guided by the computer-determined location, the radiologist uses a hollow-core needle attached to a biopsy instrument to retrieve approximately five, three-quarter-inch-long, cylinder-shaped samples of tissue from different areas of the lesion. A pathologist examines the tissue to determine whether or not it is cancerous. This procedure can also be performed using either ultrasound or MRI guidance.

• Sentinel lymph node biopsy – This procedure is performed to determine whether cancer has spread to the lymph nodes. Sentinel node dissection involves injecting a radioactive isotope and/or blue dye into a patient's breast before her surgery. This marker follows the same path that malignant cells would follow as they might spread from the tumor in the breast to the nodes. The surgery begins as the dye reaches the first layer of nodes. This first or sentinel node is identified and removed, and examined for any signs of cancer.

• Mastectomy - There are several types of procedures for surgery of the breast where cancerous tumors are found. One is a total (or simple) mastectomy, in which the surgeon removes the entire breast. During a modified radical mastectomy the surgeon removes the entire breast and some of the lymph nodes under the arm, also called the axillary lymph glands. Often, breast cancer spreads to these lymph nodes, thereby entering the lymphatic system allowing the cancer to spread to other parts of the body. Another type is a radical mastectomy in which the surgeon removes the entire breast, some of the lymph nodes under the arm and the chest wall muscles under the breast. This procedure is rarely performed now because modified radical mastectomy has proven to be just as effective with less disfigurement and fewer side effects.

In addition to diagnosis and treatment the Jefferson Breast Care Center also offers:

• Risk Assessment and Genetic Counseling and Testing – Risk assessment, genetic counseling and testing provide individuals with information and guidelines based on their risk factors, family history and/or genetic test results that will assist them and their families in the prevention of cancer occurrence and in the early detection of cancer and treatment planning. Family history is the primary indicator of an inherited risk for cancer. The staff of the Jefferson Breast Care Center, for example, evaluates a person's family history and develops a written risk assessment and a cancer screening program for each individual and their at-risk family members.

• Cancer Support and Educational Programs – These programs help patients and their families manage the physical and psychosocial effects of cancer. Some of the programs that Jefferson offers are:
• A monthly education-networking group for women with breast cancer called Facing Breast Cancer with Information and Support. Each month a leading expert in the field of breast cancer treatment, prevention and recovery speaks to the group and answers questions. Also in conjunction with the American Cancer Society, Jefferson offers the Look Good, Feel Better program, in which trained cosmetologists teach women techniques to cope with the physical effects of cancer treatment, including hair loss and skin changes.
  
• Advocacy and Survivorship Committee - Made up of individuals treated (and family members of those treated) in the Kimmel Cancer Center at Thomas Jefferson University Hospital, a National Cancer Institute (NCI) designated cancer center, this committee serves to advise physicians and administrators on patient-related issues. Committee members give input on support programs, special events, research initiatives, and much more. Representatives from the committee sit on other Jefferson University Hospital and Thomas Jefferson University-wide committees, as well as committees that are specific to cancer.
  
• Buddy Program – Jefferson’s Buddy Program puts patients in touch with someone who understands many of the feelings and questions they are experiencing, because he/she at one time also faced a new diagnosis of cancer. The buddies are trained volunteers who are cancer survivors and now provide short-term, one-to-one support to people newly diagnosed with cancer. A buddy can help patients cope with a diagnosis of cancer and the changes that can go along with it.
  
• Additional Support Programs – Navigating the New Normal is a program for young adults between the ages of 18 and 40 living with cancer or with a history of cancer. Sponsored by the Lance Armstrong Foundation, the program offers individual counseling and consultation with an oncology social worker, participation in the Buddy Program, a quarterly lecture series, networking group and a soon to be revealed website devoted to issues facing young adults with cancer. Learning to Live Better with the Stress of Cancer, is a series of supportive programs geared toward helping women who have cancer learn the skills to live better and feel better. Not your typical “talk it out” stereotype support group, this program focuses on increasing women’s options for decreasing stress and improving quality of life.

For more information or to make an appointment, please call 1-800-JEFF-NOW.