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On Oct. 21, BRA Day promotes breast reconstruction awareness, access and education

Breast Reconstruction Awareness Day – or BRA Day – offers women a unique opportunity to learn about options for breast reconstruction following a mastectomy. On Oct. 21, 2015, BRA Day events will take place all over Canada and internationally.

BRA Day events give women the opportunity to learn about breast reconstruction from both doctors and patients. Plastic surgeons give presentations about breast reconstruction options, and are available to answer questions and talk about reconstruction. Other presentations give women the opportunity to hear first-hand experiences from women who have undergone reconstruction. Education tables hosted by medical specialists and by former patients offer information and the opportunity to ask questions.

BRA Day attendees can also learn about products and services that may be useful to breast surgery patients in the exhibitor area.

Women considering reconstruction may still have questions that can only be answered by seeing actual results in person, and talking candidly with women who have already had the procedure. That’s why many BRA Day events include a Show & Tell Lounge – a safe space for women only where volunteers who have undergone reconstruction show their real-life results and share their experiences. Seeing actual results and talking openly with women who have had their breasts reconstructed helps women understand what breast reconstruction can achieve, and establish realistic expectations about the procedure.  

Access, awareness and education

BRA Day was established by Dr. Mitchell Brown, staff plastic surgeon at Women’s College Hospital, in 2011. When Dr. Brown began his practice 20 years ago, he noticed a troubling trend.

“I was seeing a number of women who would come for breast reconstruction, having had mastectomies done many years earlier,” he says. “I would regularly ask the question, what is driving you to consider reconstruction today?”

He heard many variations on the same answer: “I never knew that was an option,” or “I didn’t know it existed” or “No one spoke to me about this at the time of my mastectomy” or “I’ve struggled with a prosthesis for years and just found out that reconstruction is an option.”

“To me, that was unacceptable,” Dr. Brown says. “So the stimulus for BRA Day was to deal with that issue through three primary pillars: access, awareness and education.”

It’s difficult to find conclusive statistics on how many mastectomy patients who are candidates for reconstruction actually have the procedure, but Dr. Brown suspects those numbers remain low.

“It’s my guess that of those who are candidates for it, maybe 30 to 40 per cent now have a good opportunity to undergo reconstruction,” he says. “A good opportunity means they are told about it, that they are provided information, that they’re able to have a team that works collaboratively to provide treatment for the disease and breast reconstruction, either together or in some planned way, and that there is access to a reconstructive surgeon.”

One crucial awareness and education issue is funding coverage for reconstruction. Many women are unaware that breast reconstruction is considered medically indicated surgery, and is covered by OHIP.

“It’s important for people to know that in Ontario, and at the present time in all provinces across Canada, breast reconstruction is completely covered by health insurance,” Dr. Brown says. “I know from talking to many women that one barrier has been a perception that breast reconstruction was cosmetic and was something that they would have to pay for, and that kept some women from even considering it.”

Quality of life

Dr. Brown describes the benefits of breast reconstruction as quality of life issues, such as avoiding the use of a breast prosthesis.

“If a woman has had to have one breast removed, there is awkwardness and difficulty in trying to create balance when they get dressed every day. Women can wear a prosthesis – and prostheses can be just fine – but some women find them cumbersome, uncomfortable, mobile, and a challenge when participating in physical activity, sports and swimming.”

For some women, breast reconstruction can help restore a sense of self, well-being and femininity.

“I think it’s critical to state that reconstructing a breast is certainly not necessary for a woman to feel feminine, but for many women it’s important,” Dr. Brown explains. “I think for some people it’s about trying to just get back to where they were before they had to undergo treatment for breast disease.”

Dr. Brown stresses that reconstruction is simply an option, and isn’t something that all women who have had breast surgery will wish to pursue.

“Many, many women who undergo treatment for breast cancer are comfortable with their decision to not undergo reconstruction, and never feel that reconstructing their breast is necessary for them, and they have a perfectly happy quality of life without reconstruction. So it’s certainly not for everybody.”

There are also women who are not good candidates for reconstruction for medical reasons.

“We never want to allow reconstruction to impact the treatment of their breast disease in a negative way,” Dr. Brown says. “Women with more advanced disease may require surgical treatment, chemotherapy, radiation therapy and perhaps very close followup. Those patients may not be ideal candidates to consider reconstruction, especially at the time of their mastectomy. It may be prudent for them to complete their cancer treatment, and then once they are determined to be doing well could then undergo reconstruction at a later stage.”

BRA Day 2015

When it began in 2011, BRA Day was an ambitious Canadian project that launched with about a dozen events across the country. Only four years later, BRA Day has become an international endeavor, with events throughout Canada, the U.S., and across the world.

“In Canada, we have partnered with Willow, and Willow has done a wonderful job of building national momentum in Canada,” Dr. Brown says. “Now we’re looking ahead to where we are going to take this next. I’d like to see us use BRA Day in the future to work more on the access issue to ensure that we continue to train surgeons in communities across the country, and also to work with government for regulatory change to support the importance of breast reconstruction.”

Dr. Brown hopes to one day see legislation that ensures all women undergoing breast surgery are offered information about their options for breast reconstruction.

Dr. Brown will be participating the Toronto flagship BRA Day event on Oct. 21, 2015 from 6:45 p.m. to 10 p.m. at Centre for the Arts at St. Michael’s College School, 1515 Bathurst St. For full BRA Day event listings, visit the BRA Day website.

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  • Women's College Hospital