Making decisions about breast reconstruction after a breast cancer diagnosis
There are several different breast reconstruction options available. Talk to your breast care team about your options and preferences before making a decision.
Questions to think about include:
- do I want a breast reconstruction?
Many women decide that breast reconstruction is not for them. These women may or may not use an external breast prostheses to imitate the shape of the breast. Some women do not feel the need to replace their breast shape and adjust to their new body image without a breast.
- what type of breast reconstruction would be best for me?
- would it be better to have a breast reconstruction at the same time as a mastectomy (immediate breast reconstruction) or wait and have a breast reconstruction at a later time (delayed breast reconstruction)?
- should I have any other procedures after my breast reconstruction, such as nipple and areola reconstruction or other breast refinement procedures?
- if I only have one breast removed, will my reconstructed breast match the other breast?
"It changed my body image absolutely because, even before the bandages and stuff came off, I could see that I was in shape. I couldn't wait to rip off these bandages and just see exactly. And it was a little bit big and blah, blah, blah, but it didn't matter. The symmetry was now right. You could stand in front of a mirror and you looked like you were supposed to look and automatically you feel a whole lot better. Your clothes are hanging on you nicely, you don't have to put anything on to complete your day, you just get up like you always did... You're just not missing anything, you are all complete again."
It is often surprising to women how many healthcare professionals are involved in managing their breast cancer. The aim of a team-based or ‘multidisciplinary’ approach is to ensure that women have the best possible treatment outcomes and quality of life.
Members of the breast care team may include a general practitioner (GP), breast physician, breast surgeon, anaesthetist, pathologist, radiologist, medical oncologist, radiation oncologist, breast care nurse, breast reconstruction surgeon, physiotherapist, psychologist, counsellor and other allied healthcare professionals.
Shared decision making
Because of the range of factors that affect individual breast reconstruction options after a diagnosis of breast cancer, decisions about breast reconstruction are best made after advice from the healthcare professionals involved in your treatment and ongoing care (the breast care team).
Shared decision-making between a woman and her breast care team is important to make sure that all of the factors affecting your breast reconstruction options are considered. It is important to have reliable information about breast reconstruction so that you can make the decision that is right for you.
You do not have to make decisions at the first consultation with your breast care team. Take as much time as you need to source the information you need. Talk to your breast care team and ask as many questions as you need to before making any final decisions.
"I'm alive, if I'm going to stay alive I might as well look good. I might as well look normal. I think normal is the big thing."
Making decisions after a recent breast cancer diagnosis
It can be difficult to make decisions about breast reconstruction when you are dealing with a recent breast cancer diagnosis and decisions about breast cancer treatment. For many women, the breasts are strongly linked to femininity, motherhood and sexuality.
Studies have shown that, following a diagnosis of cancer, people do not remember much of the information given to them by healthcare professionals. This is completely normal. It can be helpful to ask for written information or to audio record the conversation.
You do not have to make decisions at the first consultation with your breast care team. Take time to think about your options and ask for more information if you need to. Waiting a week or two to consider your options will not affect the outcome of your treatment.