Category: Evidence Based Research

Shared Decision Making

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Shared Decision Making ~ Breast Reconstruction after Mastectomy March has been designated Shared Decision Making month, #SDMmonth, by a group I started following on social media, Informed Medical Decisions Foundation.  I participated recently in one of their online webinars on the topic.  I often tweet about shared decision making and in the practice of plastic surgery, and in particular breast reconstruction after mastectomy; I embrace the value of this practice. Two of the physicians that I have engaged with in the practice of shared decision making are my breast surgeon who performed my mastectomy and my micro-surgeon who performed my breast reconstruction.  They both embody the very definition of the phrase as defined here by the Informed Medical Decisions Foundation. Shared decision making (SDM) is a collaborative process that allows patients and their providers to make health care decisions together, taking into account the best scientific evidence available, as well as Continue Reading →

Genetic Testing ~ A Tough Decision

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Genetic Testing ~ A Tough Decision A recent article I read, Beyond BRCA: Testing negative and living in the “gray zone” for cancer risk, motivated me to write a personal response.  This is the story of my own genetic testing that for me was a tough decision. The article was about a fellow Twitter advocate in the breast cancer community, Stacey Tinianov. We have a bit in common as you can see by the list. Both love coffee and tweeting. You can find Stacey on Twitter @coffeemommy and me @6state Both maintain a healthy diet and active lifestyle Both gave birth to our children before the age of 30 Both had two children and nursed them Both love the “blueberry diet”… AKA…”a lifetime of following the myriad of published “cancer prevention” techniques Both diagnosed with breast cancer in our 40’s (me> a 2nd diagnosis in my 50’s) Chemotherapy – Shared Continue Reading →

Breast Reconstruction: Benefits vs. Cosmesis

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What are breast reconstruction benefits and are the benefits vs. cosmesis equal or separate? Although this question may not have been stated in these words, women considering breast reconstruction must think about this complex question. No one can come close to knowing what this decision involves except the patient themselves. Not only is it a difficult and complex process of logic but it involves a great emotional decision as well. I am speaking about breast reconstruction in very specific circumstances. Humans are faced with many unexpected events in life catapulting us to become educated about a topic we never imagined we would be learning about. A cancer diagnosis or finding you have a gene mutation putting you at high risk for breast cancer is one of those life events. Those who are considering breast reconstruction after cancer or for prophylactic reasons to greatly decrease chances of a cancer occurrence go Continue Reading →

Fears of Breast Cancer Recurrence

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Fears of Breast Cancer Recurrence Fears of breast cancer recurrence are palpable for anyone who has been diagnosed with this disease we have yet to find a cure for.  We each handle the fear differently. I had a recurrence.  I’d like to share my own experience, how I faced those fears, and how I dealt with them. As an educator for many years, I have seen the differences in personalities both in students and parents when it comes to handling what is seemingly the simplest of fears. What is catastrophic to one is barely a blip on the radar to another. There are those in life who are simply more fragile than others.  Differences in dealing with this fear of recurrence must not be judged or become fodder for accusations when we don’t always appreciate the circumstances behind. “How Do You Always Stay Positive?” Friends, relatives and family who have so Continue Reading →

Measuring the Breast for Breast Reconstruction

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The paper, Population Analysis of the Perfect Breast: A Morphometric Analysis, was a study done to determine current trends in what is considered the aesthetically pleasing breast shape in measuring the breast for breast reconstruction using a measurement of form (morphometric). It was a comprehensive survey study with cross-cultural opinions from men, women and plastic surgeons regarding ideal breast proportions. The consensus was a 45:55 ratio meaning; 45 percent of breast fullness lies above the nipple line and 55 percent below the nipple line. Simply stated, this measurement tool was determined by the study to be the guide in achieving the “perfect” breast shape for use by plastic surgeons.  History has shown that this perception of the perfect breast shape dates back to the sculpture of Venus de Milo discovered on the island of Melos in 1820. A Complex & Meticulous Procedure I was far from having the “perfect breast” Continue Reading →

Breast Cancer Patient Education Act of 2015

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The Breast Cancer Patient Education Act of 2015:  Re-introduced May 5, 2015. As stated on the Congress.Gov website: Amends the Public Health Service Act to direct the Department of Health and Human Services to provide for the planning and implementation of an education campaign to inform breast cancer patients anticipating surgery about the availability and coverage of breast reconstruction, prostheses, and other options, with a focus on informing patients who are members of racial and ethnic minority groups. To the Members of the 114th Congress of the United States: Close to 12% of women will develop invasive breast cancer over the course of her lifetime. 2015 alone will bring an estimated 231,840 new cases of invasive breast cancer. According to statistics from Breast cancer.org 60,290 new cases of non-invasive breast cancer will be diagnosed. Surprisingly, and a little known fact, there will be approximately 2,350 new cases of invasive breast Continue Reading →

Delayed DIEP flap Breast Reconstruction

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Delayed DIEP flap Breast Reconstruction ~ My Story Delayed DIEP flap breast reconstruction, my story, my experience, will hopefully give others considering this method some insight into your planning. In a perfect world immediate breast reconstruction, reconstruction done at the same time as a mastectomy, results in the best possible aesthetic outcomes for a number of reasons.  But, we all know breast cancer is not a perfect world. There are Reasons Patients have Delayed Reconstruction: Adjuvant therapy Adjuvant therapy may be necessary after a mastectomy. If there are lymph nodes that have tested positive for cancer and chemotherapy or radiation is recommended, this could delay your reconstruction. My story: No lymph nodes tested positive and radiation was not deemed necessary. However, because of the type of cancer I had, left breast recurrence from twelve years previously and a new cancer in my right breast, I was encouraged to have the Continue Reading →

Trending on Twitter #Ilooklikeasurgeon

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Trending on Twitter #Ilooklikeasurgeon Trends on Twitter and much of Social Media go at break neck speeds. Here today and gone tomorrow. There has been something trending on Twitter the past few days that inspired me to write this post. The trend followed the hash tag #Ilooklikeasurgeon and began with an article written about diversity and equality from a London surgeon, Dr. Ed Fitzgerald. A resident in surgery, Heather Logghe, MD, started the trend with pictures on Twitter.  And yes, it exploded on Social Media!  Dr. Kathy Hughes, a surgeon and one of my favorite bloggers,  even started a Facebook page to honor this community.  I was mesmerized and actually found two surgeons I follow on Twitter who posted these two pictures.                 I know Dr. Chrysopoulo personally and many of you who read my blog probably feel like you do, too, as Continue Reading →

Breast Cancer, Breast Reconstruction & New Challenges

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Breast Cancer, Breast Reconstruction & New Challenges What new challenges have you taken on since being diagnosed with breast cancer?  What have you had to deal with after losing your breasts to cancer, or finding out that you are a BRCA gene carrier? I was inspired to write this blog based on an article seen on social media from Living Beyond Breast Cancer. I include my BRCA friends in this post because I advocate for all choices of breast reconstruction and we have all had the perspective of experiencing some difficult decisions regarding our health. Events in life, good or bad, change us. They catapult us into decisions that we likely would not have come to based on the event. Being diagnosed with cancer for the second time in 2014, facing a mastectomy and then delayed DIEP flap reconstruction later that year, reset my compass. A Side Trip on my Continue Reading →

Scar Healing: Post DIEP flap Surgery

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Scar Healing: Post DIEP flap Surgery Scars, scar healing, and scar therapy  after breast reconstruction surgery is a frequent topic of discussion on DiepCJourney support group page. I can share with you what I have learned about these topics after phase 1 & 2 of my DIEP flap surgeries. What Forms the Scar? You may have heard of collagen. Collagen is a structural protein occurring in our bodies. Collagen goes to work and is produced by your body, in simplest form, after skin is disrupted through a surgical incision. It repairs and heals the wound because of its fibrous, connective properties. It is what forms the scar when your body goes through its natural healing process. Healing is Individual but Maintaining Health is Important! We are all unique and individual when it comes to healing. Your skin color, genetics, and overall health are important factors in the individual outcomes and Continue Reading →