Reconstruction in other situations
Some women are advised to have an unaffected breast removed in order to reduce the risk of getting cancer in the future. Different reconstructive techniques may be needed in these situations.
Options for patients with a partial mastectomy (wide local excision)
If only part of your breast needs to be removed (“lumpectomy” or “wide local excision”), there is often no need for reconstruction. Wide excision of the tumour is usually followed by radiotherapy and once things have settled down often an acceptable degree of symmetry is achieved without any further surgery.
Sometimes, if the treated breast ends up rather smaller, you may want the other breast adjusted to match. Sometimes it is possible to add tissue to the treated breast using either a flap or lipofilling.
For some women, particularly those with large breasts, it is possible to carry out a wide excision of the breast tumour and reshape the breast making it smaller than before. At the same time the opposite, unaffected breast is also reduced in size to match. This technique is called “therapeutic mammaplasty”. This is ideal if you need a partial mastectomy and are prepared to have (or had always wanted) smaller breasts.
Some women seem to be at particular risk of getting breast cancer. If you have several close relatives who have also had breast cancer, particularly occurring at a young age, it is possible that there is an underlying inherited genetic basis for your breast cancer.
Often the genetic basis is unknown, but some women carry genes such as BRCA 1 and 2 that are known to be associated with breast and ovarian cancer. Sometimes you can be at increased risk of getting breast
cancer because of previous radiotherapy to your chest for something else, such as lymphoma. Some women who have had breast cancer on one side are known to have a particularly high risk of developing cancer on the other side.
In each of these situations you may be offered a “risk reducing” mastectomy before the development of breast cancer, usually with immediate reconstruction.
You will be advised by your breast care team what your likely cancer risk is and you may be offered a consultation with a clinical geneticist to explore this further. In most situations you will be given a statistical probability – this does not mean that breast cancer will definitely occur, but that your risk may be higher than in the average woman.
You can choose to have close surveillance using scans or mammograms with the intention of detecting a cancer at an early stage or, alternatively, opt for risk-reducing mastectomy perhaps on both sides in order to minimise any risk. In this situation immediate reconstruction will almost always be possible and any one of the reconstructive techniques in this guide might be appropriate
Reconstruction for benign (non cancerous) breast problems
Some women who do not have breast cancer will need operations similar to those described in this booklet. Typical examples are women with very marked underdevelopment of one or perhaps both breasts, or patients with abnormal development of the chest wall
Introduction to breast reconstruction
When to have breast reconstruction
Operations to make a new breast
Further operations and nipple reconstruction
Where can you have breast reconstruction?
Other questions and where to get more information