Women's Health Matters

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Living with Breast Cancer

If breast cancer is discovered and treated when it is still localized to the breast, the five-year survival rate may be as high as 90 per cent. In addition, the discovery of breast cancer at a very early stage may permit effective, local treatment with less radical surgical procedures, such as a lumpectomy.

After mastectomy surgery, women have a number of options to make the appearance of the loss of the breast(s) less obvious. These options include:

Breast Prosthesis

If you are considering buying prostheses, financial assistance forms are available through the retail outlets where prostheses are sold. Reach to Recovery is a program of the Canadian Cancer Society that offers temporary prostheses.

Reconstructive or breast implant surgery

Reconstructive surgery is an operation performed to restore a woman's breast mound after a mastectomy. Increasing numbers of women are opting for reconstruction over an external prosthesis. Deciding to have reconstructive surgery is not a decision to rush into. Instead, take time to gather information and talk to a plastic surgeon and your doctor about what is best for you.

Breast reconstruction is accomplished using one of two methods: implants, or living tissue. Implants are usually used in combination with a tissue expander. Living tissue uses a woman's own tissue from another part of her body – usually from her abdomen (called a TRAM flap, or transverse rectus abdominus musculotaneous) or from her back (called a LATS, or latissimus dorsi, flap). Each of these procedures is explained below.

Saline implant with tissue expander

In order to produce a pocket for the breast implant, a tissue expander resembling an empty implant is placed behind the muscle on the chest. Over a period of three to six months, sterile saline is injected into the expander through a port under the skin. Once the pocket has reached a sufficient size, surgery is scheduled to remove the expander and replace it with a breast implant.

Some centres may offer single-step procedures. These may use expanders designed to remain in place rather than be replaced with an implant, or they may use implants and regenerative tissue products to augment the amount of skin and tissue available for reconstruction.

TRAM flap

This is a surgical technique which uses the abdominal skin, fat and muscle tissue to create the breast. Women who undergo this operation must have a sufficient amount of abdominal tissue to form the breast mounds. Tissue from the abdominal area is tunnelled through the chest and brought out through the mastectomy scar to form a natural-appearing breast mound. The site from which the tissue was removed is closed, giving a "tummy tuck" effect. This operation leaves a scar across the entire width of the lower abdomen that can be hidden by a swimsuit or underwear.

LATS flap

This surgical procedure uses the broad fan-shaped back muscle (latissimus dorsi) with the overlying skin to create the breast. A breast implant is usually added to provide volume. The operation leaves a visible scar on the back.

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