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Reconstructive Surgery

Helen

Double Mastectomy and Breast Reconstruction

Helen had a strong history of breast cancer in her family- five of her aunts had been diagnosed with the disease whilst another aunt underwent a preventative mastectomy over 30 years ago.

In June 2011, Helen was diagnosed with breast cancer and the lump was subsequently removed. However when the lump was analysed it was confirmed that she had in fact been misdiagnosed and in reality the surgeon had removed a benign, non-cancerous lump. In light of this, Helen made the decision to have a preventative double mastectomy followed by immediate reconstruction instead of her annual mammograms as she did not want to go through that experience again.

Helen’s family history put her in a high risk category and she felt it was likely she may be diagnosed with breast cancer at some point in her life. Although Helen's family had a BRCA gene test (a blood test that uses DNA analysis to identify harmful changes in either one of the two breast cancer susceptibility genes — BRCA1 and BRCA2), no gene mutations were found were found in any family members. Despite this, the doctors at the time told her that she almost certainly had a genetic predisposition to breast cancer based on her family history.

Aged just 39, Helen had the double mastectomy and reconstruction performed at the same time by Mr Martin Jones. The breast tissue was analysed afterwards and there were found to be pre-cancerous changes so Helen felt confident in her decision to have preventative surgery. Helen feels she can now live her life free from the worry of a breast cancer diagnosis.

Source: www.nhs.uk and www.breastcancercare.org.uk

A mastectomy is carried out under general anaesthetic, so you'll be asleep while it happens. During the operation, a horizontal or diagonal cut is made across your breast so the tissue can be removed. The amount removed will depend on the type of mastectomy you're having.

The surgeon will usually put one or two drainage tubes in place to stop fluid building up in the breast space. These may be left in for a few days.

There are many techniques which can be used to create a new breast following a mastectomy. The technique used is dependent on numerous factors which are fully explored during the consultation phase with your surgeon. An in-depth explanation of the techniques used can be found here.

Implant breast reconstruction tends to the most straightforward and quickest method. Implant reconstruction involves restoring the shape and volume of the breast using a breast implant. Breasts reconstructed in this way tend to be close to a natural breast shape, but are firmer and move less naturally than those using your own tissue. This can mean it’s more difficult to get a natural shape when one breast, rather than both, is being reconstructed.

The reconstructed breast will not droop with age and may look higher than the other breast, particularly as you get older. If you lose or gain weight, this will affect the natural breast but not the reconstructed breast, causing a difference in shape and size. At some point you may need more surgery to the reconstructed breast, or to the other breast, for a better match.

Implant reconstruction is often recommended for women with small and firm breasts, as it avoids the need for more extensive surgery using tissue from another part of the body.

There is no set lifespan for a breast implant but it will usually need to be replaced at some point and further surgery will be required at this stage.

For further reading about breast reconstruction at The McIndoe Centre:

Everything you need to know about breast reconstruction surgery

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