Integrating breast cancer surgery and reconstruction

October 12, 2023 | by NorthShore – Edward-Elmhurst Health

One of the major advantages of receiving cancer care at an integrated, multidisciplinary breast health center is the opportunity to undergo reconstruction surgery at the same time as cancer surgery. Expert plastic surgeons are fully integrated members of NorthShore – Edward-Elmhurst Health breast oncology teams.

“All of our patients are offered reconstruction and that includes a multitude of options,” said fellowship trained oncology surgeon TJ Smith, MD, who sees patients at NorthShore Swedish Hospital. “I am a cancer surgeon and I tell my patients that my first goal is to remove the cancer with the lowest rate of recurrence and the highest survival rate. But a close second goal is for them to have a cosmetic result they are happy with.”

Research has shown that positive cosmetic outcomes correlate with quality of life and patient satisfaction. External appearance plays a big part in most people’s self-image, and it’s important for patients to regain body confidence following surgery, said Dr. Smith. Positive cosmetic results and accompanying confidence also help patients return to normal sexual health and relationships.

Reconstruction following mastectomy is just one of the options. For example, Dr. Smith recently cared for a young patient with large breasts who had lost a significant amount of weight before her cancer diagnosis. She was able to undergo a lumpectomy and breast reduction surgery at the same time.

The median age of breast cancer patients is 62 and Dr. Smith and his colleagues see many women who are otherwise healthy and are having their first major encounter with the healthcare system. Having everything from coordinated appointments with both oncology and plastic surgeons, to surgical scheduling and insurance approvals, handled in one place is a major benefit, especially for patients who may be scared or anxious and not sure of what questions to ask.

NorthShore – Edward-Elmhurst Health is a national leader in oncoplastics — breast surgery with a focus on cosmetic outcomes to optimize an individual’s breast size and shape. NorthShore expert Katherine Kopkash, MD, leads American Society of Breast Surgeons training in the field.

Fellowship-trained surgeons and microsurgeons are experienced in the full range of advanced options, including skin-sparing and nipple-sparing mastectomies, Wise pattern mastectomies, and advanced microsurgery lymph node procedures to reduce the risk of lymphedema. Autologous reconstruction using tissue from the patient’s own body rather than implants is also offered. Reconstruction is covered by insurance, Medicare and Medicaid.

Not every patient is a candidate for nipple-sparing mastectomies, as the decision is based on the location and size of the cancer as well as breast size, explained Dr. Smith. The only circumstance where reconstruction is not currently recommended is in cases of inflammatory breast cancer, though there is intense study and debate on the topic, he added.

“Patients sometimes ask if getting reconstruction will increase their chance of cancer recurrence and the answer is no, it will not,” said Dr. Smith. With coordinated surgical schedules, reconstruction will also not delay cancer treatment, which is another common patient concern.

While it is important to note that reconstruction surgery is different than a strictly cosmetic breast augmentation procedure, the goal is still to get patients’ breasts to look exactly the way they want them to look while removing the cancer, said Dr. Smith.

Learn more about breast cancer surgery and reconstruction.

Breast cancer is a journey that no one expects to take. The cancer experts at Edward-Elmhurst Health will partner with you every step of the way. Learn more.

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