Breast Cancer Treatment Part 1: Surgery, Radiation and Reconstruction
Jun 19, 2024
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Dr. Michael Bernstein, a radiation oncologist at Memorial Sloan Kettering, explains the pivotal role of radiation therapy in breast cancer treatment, discussing planning, side effects, and patient experiences. Dr. Michelle Coriddi, a plastic and reconstructive surgeon, shares insights into various reconstruction techniques, emphasizing the importance of body image post-treatment. The two experts address lumpectomy versus mastectomy options, patient testimonials, and the emotional journey of navigating breast cancer care. Their expert advice empowers patients to make informed choices.
Understanding the differences between lumpectomy and mastectomy, including the impact of genetic factors like the BRCA mutation, enables informed surgical decisions.
Advancements in radiation therapy provide patients with targeted, less toxic treatment options that help minimize recurrence risk after breast conserving surgeries.
Deep dives
Understanding Surgical Options for Early Stage Breast Cancer
When diagnosed with early stage breast cancer, patients typically face two surgical options: breast conservation through lumpectomy or mastectomy. Lumpectomy involves removing only the cancerous area of the breast, often followed by radiation therapy, preserving most of the breast tissue. Mastectomy, on the other hand, consists of the complete removal of the breast and is recommended in certain circumstances, such as when there's a high risk of recurrence due to genetic factors like the BRCA mutation. Most patients are suitable for breast conservation, which yields outcomes comparable to mastectomy, allowing them to maintain breast integrity while emphasizing the importance of informed decision-making.
The Role of Radiation in Breast Cancer Treatment
Radiation therapy plays a crucial role in the treatment of breast cancer, particularly after lumpectomy to minimize the risk of recurrence. It uses targeted x-rays to create an unfavorable environment for cancer cells, ensuring that any remaining cancerous cells are effectively dealt with. The advancements in radiation technology have led to more precise and less toxic treatment plans, allowing patients to complete their radiation therapy in fewer sessions than in the past. Patients should be well-informed about radiation's side effects, including localized skin reactions and fatigue, and should maintain active lifestyles to help mitigate these effects.
Exploring Options for Reconstruction Post-Mastectomy
After undergoing a mastectomy, patients have several reconstruction options, including implant-based reconstruction or using their own tissue. Implant reconstruction begins with a tissue expander, which can be adjusted post-surgery, leading to either permanent implants or autologous tissue from areas like the abdomen. Personal preferences significantly shape these decisions, with some opting for implant reconstruction while others may choose no reconstruction or a flat closure. Additionally, options like nipple-areola tattooing allow patients to enhance their appearance post-surgery, further emphasizing the importance of personalization in the treatment journey.
In this episode (part 1 of 2), Dr. Diane Reidy-Lagunes speaks with a team of MSK experts to demystify three breast cancer treatment options: surgery, radiation, and reconstruction. Breast surgeon Dr. Tracy-Ann Moo explains the difference between a lumpectomy and a mastectomy, and why one isn’t always better than the other. Radiation oncologist Dr. Michael Bernstein discusses the role of radiation therapy in the treatment of breast cancer. Plastic and reconstructive surgeon Dr. Michelle Coriddi describes various breast reconstruction and preservation techniques, which can help patients maintain a positive body image after treatment.
Episode Chapters: 1:27 - Surgery options: lumpectomy vs. mastectomy 2:32 - Family history, genetics, and BRCA mutation 3:30 - Which surgery has the best outcomes? 5:16 - Surgery patient testimony 6:46 - Nipple-sparing mastectomy 7:36 - What is radiation? 8:49 - Why is radiation needed? 10:11 - What does a typical radiation plan entail? 11:19 - Radiation patient testimony 12:38 - Radiation side effects & how to mitigate them 14:25 - Exercise during treatment and recovery 15:10 - Reconstruction options after surgery 18:22 - Recovery after reconstruction 19:10 - Insurance coverage for breast reconstruction 19:31 - Reconstruction patient testimony 20:58 - Nipple tattoos and 3D areola reconstruction 22:00 - Surveillance and risks of breast implants 23:02 - Advice for patients