By Marshalee George, Kimlin Tam Ashing

There are several surgical options for treating breast cancer, but it is your stage of breast cancer that determines which surgical options are best for you. Breast reconstruction is when a surgeon rebuilds the breast using one of two main types of breast reconstruction: implant or your own tissue (tissue from belly, back, thigh, or buttock). The figure illustrates sources of breast construction.

breast-reconstruction
Illustration by Kathryn Born
Breast reconstruction options.

Sometimes, based on the size of your tumor, your doctor may recommend a lumpectomy with or without a sentinel lymph node biopsy followed by several weeks of radiation with minimal change in the size of your breasts. But you may prefer to have the whole breast removed (mastectomy) and perhaps have a breast reconstruction. Regardless of what your doctor recommends and your preferences, here are some things you may find it helpful to consider as you decide among options:

  • How do you feel about having your whole breast removed?
  • How do you feel about having part of your breast removed?
  • How do you feel about having radiation therapy?
  • How quickly do you want your treatment to be completed?
  • How will you cope with travelling daily to get radiation therapy for several weeks?
  • Will you want to have immediate breast reconstruction or wait some months after surgery?

There are no right or wrong answers to these questions — it is based on your values and preferences. Each woman is different and will approach their treatment decisions differently in a way that may be personal, social, financial, religious, or cultural.

Some women may feel compelled to keep their breast and choose a lumpectomy even though that wasn’t recommended by their surgeon because of the stage of their breast cancer. If you are that person, you should speak to your doctor or psychologist to help you determine why you are willing to put your life at risk by not getting the recommended type of surgery. In this case, a mastectomy would better ensure that all your cancer is removed and your risk of cancer coming back will be minimal.

If you feel strongly about not getting radiation, then lumpectomy should not be an option for you because you will not be receiving the standard treatment for your breast cancer. Mastectomy and possible breast reconstruction may be your only option in such a case, according to standard NCCN guidelines.

The type and timing of breast reconstruction may depend on your need for further treatment post–breast surgery, such as chemotherapy or radiotherapy. Breast reconstruction is optional — it’s not required and won’t change the outcome of the cancer.

Take the time you need to make the right decision after hearing all the options available to you for your treatment. Every decision you make may impact your survival positively or negatively. You can discuss your concerns with your doctor, family, and friends. Feel free to contact your breast specialist or nurse if you have additional questions before you make your treatment decision.