Monday Medical: Making sense of breast cancer surgery options
October 6, 2013
Steamboat Springs — One in eight American women will be diagnosed with breast cancer, and many find the best way to manage the mind-numbing chaos that comes with a breast cancer diagnosis is to explore the various surgical and reconstructive options available to them.
Steamboat Springs residents now are being offered a ray of hope in the midst of the decision to undergo mastectomy surgery, in the form of an immediate reconstruction procedure performed at the time of mastectomy.
Dr. Lisa Hunsicker, who pioneered her innovative technique more than 10 years ago, has recently teamed with general surgeons Dr. Allen Belshaw and Dr. Mark Hermacinski to offer this tandem surgery at Yampa Valley Medical Center.
This outpatient procedure offers a shorter recovery and fewer surgeries than traditional breast reconstruction, and it alleviates the need for uncomfortable tissue expansion and more invasive flap surgeries. It also offers patients the emotional benefit of emerging from mastectomy surgery with fully reconstructed breasts.
Although the number of reconstructive surgeons who offer this technique is growing, most still rely on traditional implant reconstruction using tissue expanders.
The tissue expander is a modified saline implant with a valve that allows for more saline to be added over the course of several weeks, forcing the tissue to stretch. In traditional breast reconstruction, the expanders are inserted during the mastectomy surgery so that a pocket can be formed under the skin and chest muscle.
Once the tissue has been stretched to allow for the volume of the new implant, a subsequent surgery is performed to exchange the tissue expander for a permanent implant.
Alternatively, Hunsicker performs her "direct-to-implant" procedure in tandem with the general surgeon, who begins the mastectomy portion of the surgery by removing the breast tissue from one side of the patient.
As the general surgeon finishes on the first breast and moves on to the second, Hunsicker steps in to begin immediate placement of a breast implant on the first side. Once the mastectomy has been completed on the second breast, Hunsicker then finishes the case by placing the second implant.
Jennifer, a patient who has undergone the direct-to-implant procedure, reflects on her own personal experience.
"Breast cancer is an emotional roller coaster," she says candidly. "As I was faced with the severity of cancer, surgery, chemotherapy and radiation, there were many emotions that ran rampant. Having a direct-to-implant procedure took one bit of that stress and unknown away.
"As it is, I have struggled with my change in appearance and the insecurities that go along with being a bald cancer patient…Waking up from a bilateral mastectomy with implants in place has made me feel a bit more 'whole' while I continue my cancer treatment. I am thankful for this procedure."
"We encourage all of our patients to explore their reconstruction options, so they can pursue the surgical solution that works best for them," Hunsicker says. "It's a personal decision, and one that only they can make.
"For many of our patients, the direct-to-implant procedure is a wonderful choice. And for all of our patients, they are able to engage in their breast cancer treatment with more confidence because they are fully informed of all the options available to them."
Lisa Bankard is the director of wellness and community education at Yampa Valley Medical Center. She can be reached at email@example.com.