As we mark Breast Cancer Awareness Month this October, we take a look at the psychological aspects behind breast cancer and breast reconstruction after mastectomy. In this regard, we spoke to Dr Adnan Tahir, a Plastic and Reconstruction Surgeon with special focus on breast reconstruction at Dubai Cosmetic Surgery clinic.
HAYATI: Is there a standard treatment for breast cancer?
Dr Tahir: According to the World Health Organization (WHO), breast cancer is the leading cause of cancer related deaths in women, and accounts for over half a million deaths worldwide. Although there are multiple risk factors involved in developing breast cancer treatment, the standard treatment worldwide remains early diagnosis and awareness.
HAYATI: What does mastectomy involve?
Dr Tahir: Early diagnosis of breast cancer is followed by a surgical procedure of removing the entire breast, known as Mastectomy, or part of the breast referred to as Wide excision. This is usually combined with a procedure to either sample or remove lymph glands in the arm pit. Depending on the severity of the cancer, subsequent radiotherapy or chemotherapy is also needed.
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HAYATI: What psychological impact can breast cancer surgery have on a person?
Dr Tahir: The psychological and personal impact of breast cancer on a person is tremendous and cannot be underestimated. Loss of confidence, low self-esteem, depression, are common in individuals who have the above surgery and it is a reason for breakdown of relationships. Furthermore, fear of surgery and complex treatments on offer can often add to the patient’s anxiety.
HAYATI: After mastectomy, what does breast reconstruction aim to do?
Dr Tahir: Breast reconstruction aims to address the above psychological issues by creating a breast in order to restore volume and symmetry with the other breast where necessary. This requires a procedure involving either transplanting one’s own tissue usually from the abdomen (DIEAP flap) or occasionally from other areas such as the buttocks, thighs, or back.
HAYATI: What other types of breast reconstruction are there?
Dr Tahir: There is another commonly used option in breast reconstruction. This involves the use of breast prosthesis after a period of tissue expansion using a tissue expander under the mastectomy scar. The choice of the procedure varies per patient depending on the original cancer treatment, availability of tissue for flaps, and the fitness of patients to have these operations. Usually this is decided in conjunction with a breast team comprising a breast surgeon, Plastic surgeon, and breast care nurses who educate the patient on the various methods.
HAYATI: What are the benefits of breast reconstruction to the well-being of a breast cancer survivor?Dr Tahir: There are numerous studies available that have highlighted the benefits of breast reconstruction in improving the psychological and physical well- being of an individual who have gone through breast cancer treatment and reconstruction. This is considered as a journey that one has to make with their surgical team in order to restore the well-being of the patient as it was before the diagnosis of breast cancer was made. This is surgically possible and I would encourage all patients with breast cancer to discuss reconstructive options with their surgical team. Improvements in quality of life, anxiety, depression and overall body image are some of the important benefits of breast reconstruction.
HAYATI: How soon should one consider breast reconstruction after diagnosis?
Dr Tahir: Due to current techniques available, it is important to involve the patient early in the decision making process regarding their treatment in order to limit the psychosocial impact of breast cancer on their lives. Although severe depression is rarely seen nowadays, treatment anxiety, fear of disease recurrence, changes in body image and sexuality remain genuine concerns and have to be addressed early after the diagnosis of breast cancer by patient education, ideally by breast care nurses familiar with these issues and who form a part of the multi-disciplinary breast team dealing with breast cancer.
HAYATI: Is breast reconstruction a standard treatment across the board?
Dr Tahir: It is very important for all professionals treating breast cancer including doctors and nurses to identify and address the psychological issues in patients and treat each case individually as the psychological needs vary tremendously.
HAYATI: How vital is breast cancer awareness?
Dr Tahir: Breast cancer awareness is the key in preventing deaths from this deadly disease by early diagnosis and treatment. Due to cultural and social complexities and taboos, we as a society have a long way to go in this regard and make every possible effort to educate women about breast cancer.
HAYATI: What steps can facilities/hospitals take to ease the weight of breast cancer on survivors?Dr Tahir: There are a lot of things that facilities can do to ease the off but it all depends on the operations of the said facility. For instance, at Dubai Cosmetic Surgery clinic, the breast reconstruction surgeons offer free consultations on the same. We believe this takes some of the psychological weight off the patient, and helps them in decision-making and comparing and choosing the best breast reconstruction surgeons out there.