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Reconstruction after lumpectomy?

Page last modified on: September 18, 2008
Question from Kathy: This year was my third bout with BC. I have had a lumpectomy and lymph node removal in both breasts. I asked my surgeon about a referral for reconstruction. He said that breast reconstruction referrals are not made when a lumpectomy is performed, only when a complete mastectomy is done. Does this sound right? Any suggestions on how I should proceed?
Answers —Maurice Nahabedian, M.D.: I can say that probably 95% of women who have lumpectomies will not require any type of reconstruction. However, there are about 5% of women who have significant contour abnormality of the breast following lumpectomy. If this has occurred, there are reconstructive techniques to improve the contour of the breast. These techniques can include use of the latissimus dorsi flap, TRAM flap, or implants.
Marisa Weiss, M.D., president and founder: The procedure of taking part of the latissimus dorsi muscle laparoscopically and flipping it into place—is this a reasonably manageable procedure that has a high success rate?
Maurice Nahabedian, M.D.: The latissimus dorsi flap is occasionally performed now using laparoscopic techniques. This can be useful in certain situations where a small portion of the breast needs to be reconstructed, rather than the entire breast. The laparoscopic techniques will be somewhat limited in their ability to harvest large amounts of skin, fat and muscle.
Marisa Weiss, M.D., president and founder: Plastic surgical reconstruction of a breast really is a marriage between fine medicine, surgery, and artwork. Also, there is only one of each of you, and each of you has her own self-image and set of expectations and desires. Reconstruction is such an individualized process. In order to get the best results, there has to be good communication with your doctor. You can really help your doctor help you if you put your concerns and expectations "on the table."

On Wednesday, November 19, 2003, our Ask-the-Expert Online Conference was called Breast Reconstruction. Maurice Nahabedian, M.D. and Marisa Weiss, M.D. answered your questions about different techniques in breast reconstruction, the pros and cons of implants and body tissue transfers, when you might want to reconstruct, and many more issues related to rebuilding your breast/s after breast cancer surgery.

The materials presented in these conferences do not necessarily reflect the views of breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.

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Meet the Experts

Maurice Nahabedian, M.D. is director of the Center of Reconstructive and Aesthetic Surgery of the Breast and associate professor of plastic Surgery at Johns Hopkins.

Marisa Weiss, M.D. is a radiation oncologist specializing in breast cancer and the founder, president, and guiding force behind Breastcancer.org.

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