Episode 3: Breast Reconstruction and Breast Sensation

In Episode 3 of the DiepCJourney podcast I discuss breast reconstruction and breast sensation with two surgeons who have performed this procedure together in their practice. Dr. Anne Peled and Dr. Ziv Peled work in tandem in the operating room to preserve and restore sensation to the breast for those affected by breast cancer. The paper published by Dr. Anne and Ziv Peled can be found in the PRS Global Open under the title, Nerve Preservation and Allografting for Sensory Innervation Following Immediate Implant Breast Reconstruction PRS Global Open Dr. Anne Peled, who was diagnosed with breast cancer herself, was torn about what surgical option to choose for her own diagnosis; a lumpectomy, oncoplastic surgery or mastectomy. She was aware, due to standard training of breast surgeons, a mastectomy would mean the likelihood of losing sensation to her breasts. Most patients who undergo mastectomy are left numb and as she Continue Reading →

FDA Approval of Breast Cancer Vaccine

The FDA recently opened the door for a phase 1 of a particular type of breast cancer vaccine to begin this spring. This Phase 1 clinical trial of the vaccine was approved for use in humans with triple negative breast cancer, considered to be one of the most difficult types of breast cancers to treat. As a patient advocate, the FDA approval of the phase 1 clinical trial for this breast cancer vaccine comes as good news. There are various types of breast cancer. A majority, around 80%, are estrogen receptor positive often referred as ER+. This means the cancer cells grow in response to the hormone estrogen. Women and men who have breast cancers that are ER/PR+ are prescribed medication that blocks the hormone receptors, preventing hormones from binding to them thus helping the breast cancer from coming back. A pathology report for what type of breast cancer you Continue Reading →

Shared Decision-Making Is Your Surgeon Practicing it, and Why Should You Care?

By Terri Coutee and Minas Chrysopoulo, MD FACS I feel very passionate about opportunities to educate others on the topic of shared decision-making. Shared decision-making is when the patient and physician work as collaborative partners in deciding a treatment plan that is best for the patient. After recording a ZOOM interview with Dr. Minas Chrysopoulo recently, the topic came up as it often does. Dr. C said to me, “Let’s write about it together.” It took no time for me to agree to co-author this blog! What Shared Decision-Making is NOT… As a patient advocate for all options of breast reconstruction, I have the opportunity to speak to others who are planning or recovering from all types of reconstruction. I ask if they felt fully engaged in their decision process for their reconstruction. It is apparent to me that they were NOT when they tell me they were not even Continue Reading →

Nerve Graft: Restoring Sensation to the Breast

Sensation to the breast is important to most women. Nerves in the breast provide this sensation. This feeling provides protection from heat and cold temperatures. The breast is an erogenous zone for several women providing sexual sensation, especially in the nipple and areola area. Nerves are cut at the time of mastectomy when cancerous tissue is removed leaving numbness to the chest. During breast reconstruction, some surgeons perform a procedure using a nerve graft restoring sensation to the breast. Location of the Nerves Restoring Sensation to the Breast The breast is comprised of an intricate web of nerves running through the breast tissue. Surgeons tend to speak about the two sides of the breast looking at it from the front. Draw an imaginary line from the arm pit area running down the side. This is the area of the chest referred to as the lateral area. The area at the Continue Reading →

DiepCJourney Celebrating Five Years in Unprecedented Times

Five years ago, on March 17, 2015, I published my first blog for DiepCJourney.com. I felt excited and anxious. Today, on March 17, 2020, those feelings, excitement and being anxious manifest themselves in a completely different way. We are at the tip of the iceberg in the United States as we grapple with how to deal with a global pandemic, the worldwide Coronavirus outbreak. This blog will be marked as a time capsule. I had no idea DiepCJourney would be celebrating five years in unprecedented times. I had an idea what I might write in this blog as 2020 rolled around knowing it was the fifth anniversary year. But now things have changed. I want to share my concerns and gratitude to all of the amazing readers over the past five years. My Concerns for Readers of DiepCJourney at this Unprecedented Time The blog continues to grow and evolve. What Continue Reading →

Breast Advocate App: An Interview with Founder Minas Chrysopoulo, MD

We are fortunate to live in a time when apps on mobile devices become tools to help us with our treatment options for a number of health-related issues. The focus of my blog and mission of my nonprofit Foundation is to empower women and men with information to make an informed decision about options for breast reconstruction after mastectomy. I have the distinct pleasure to present the reader with a decision tool, the Breast Advocate App and an interview with Founder, Minas Chrysopoulo, MD, FACS. I began my work as a patient advocate in early 2015 shortly after having my successful DIEP flap breast reconstruction. At the time of my second diagnosis in April of 2014, I was given all my options for breast reconstruction by my breast surgeon. I am grateful to her. I was handed a packet of brochures from implant manufacturers, local support groups, photos and explanation Continue Reading →

How to Join the BC3 Twitter Talk in Five Easy Steps

BC3C is the Breast Cancer Coordinated Care Interdisciplinary Conference being held in Washington, D.C. February 27-29, 2020. This conference includes a wide range of medical specialists who care for breast cancer patients. As an introduction to what the conference will be about, you can join us on January 24, from 1:00 PM – 2:00 PM ET to find out more. This blog will tell you how to join the BC3 Twitter Talk in five easy steps. Step One of Participating in the BC3 Twitter Talk You will need to have a Twitter account. It’s very easy to open one if you do not have one now. Open Twitter from your computer, phone or tablet. You will then need to type in your phone number or email address in the first text box. After that, set up the password you want to use. Participating in Twitter Talk is a bit easier Continue Reading →

A Commentary: A Study Marking Patients for DIEP Flap Surgery

Plastic and Reconstructive Surgery Global Open is an open source journal available for everyone to read. I refer to it frequently. The articles I focus on are those regarding breast reconstruction. The article entitled, “A Standardized Approach to Deep Inferior Epigastric Perforator Flap Marking” was recently brought to my attention by a plastic surgeon, Dr. Roy Kim. I know Dr. Kim via social media and speaking to him at the annual Plastic Surgery conference. I recently had the privilege of meeting two of the authors of the paper, Dr. Edward Reece and Dr. Sebastian Winocour both of Baylor College of Medicine. I think he knew I would find this study fascinating. I decided to write a commentary on this study of marking patients for DIEP flap surgery. A Patient Advocate’s Thoughts: A Study Marking Patients for DIEP Flap Surgery I chose DIEP flap as the method of breast reconstruction after Continue Reading →

Nutrition and Diet after DIEP flap Breast Reconstruction

Are you more aware of your nutrition and diet after DIEP flap breast reconstruction? I certainly am and I hear the same from many women. When breast cancer is the driving reason behind having this intricate surgery, it is little wonder nutrition and diet become a focus for so many. At the same time, I hear a lot of inquiry about what is the best way to eat a healthy nutritious diet after breast reconstruction.  The one factor that changes this is the “tightening down” of the tummy during this surgery. With the tummy tissue being used to reconstruct the breast, the tummy area is pulled down similar to a tummy tuck. Many women talk about the feeling of having less room, filling up quicker, and feeling like they can’t eat as much after DIEP flap breast reconstruction. Where do your Food Values about Nutrition and Diet come from? The Continue Reading →

How Shared Decision-Making Works in Breast Reconstruction

The term shared decision-making can be used across multiple disciplines in medicine. The process of shared decision-making takes place when a patient and their health care provider work together to make a health care plan that is best for the patient. It is a topic I speak of often in my community as a patient advocate for all options of breast reconstruction after mastectomy. Let’s talk about shared decision making and how it works in breast reconstruction. How Shared Decision-Making Works for the Patient Whether implants are chosen or you choose to use your own tissue, being your own best advocate and doing your homework prior to your initial consult is beneficial. Prepare your questions and findings ahead of time. Your physician will go to the consult prepared. Doesn’t it make sense then, that you are just as prepared? This first step will empower you with a voice to communicate Continue Reading →