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Reconstruction worth it in Stage IV?

Page last modified on: October 16, 2008

Question from Carol: I have Stage IV breast cancer and had a left breast mastectomy. I would like to have my other breast removed and have reconstruction and yet I find that I don't have support for this decision. I hear that I should concentrate on staying healthy. Should I even consider reconstruction, or am I crazy to even consider what I think is a good option?: Answers —Jennifer Sabol, M.D., F.A.C.S.: While we never used to encourage patients with Stage IV disease to look for long term solutions, medicine has changed quite a bit. We now have breast cancer patients with metastases that are living with their cancer well beyond even 10 years. Given this, a reconstruction with a short period of disability may be very, very acceptable if your cancer is one that seems to respond well to treatment and is fairly local. Whether or not you consider a mastectomy on the contralateral breast is much more controversial. Some patients will actually require surgery on the opposite breast to simply make a reasonable match when they reconstruct the affected breast, and in this instance a mastectomy is very reasonable. I think it's important to make sure that your expectations are appropriate and that by removing the opposite breast you don't have the expectation that this will somehow increase your chances of surviving this cancer, but that you are doing this for peace of mind and improved body image. In the right circumstance, I think your choice is not unreasonable. I hope that you will find someone that is supportive of your decision.; Joseph Serletti, M.D., F.A.C.S.: Our practice has been to not categorically exclude any patient from breast reconstruction, even those with advanced stage disease. Our experience has been that many of our patients with advanced disease have remained alive years after their reconstruction. Of those patients who have died from their disease, they have lived an average of just under four years following their reconstruction. It has been our experience that providing a patient with advanced disease a reconstruction for four or more years has been a very positive experience for the patient and their family.

On Wednesday, May 16, 2007, the Ask-the-Expert Online Conference was called Reconstruction Updates. Joseph Serletti, M.D. and moderator Jennifer Sabol, M.D. answered your questions about breast reconstruction.

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

Joseph M. Serletti, M.D., F.A.C.S. is professor of surgery and chief of the Division of Plastic Surgery at the University of Pennsylvania. He is a pioneer in the field of free flap autologous breast reconstruction.

Jennifer Sabol, M.D., F.A.C.S. is a breast surgeon who directs the newly developed Breast Care Center at Lankenau Hospital in Wynnewood, Pa. Among her many interests, Dr. Sabol spearheads several research initiatives to advance the care for women with breast cancer and improve methods of breast cancer detection and treatment.