Making Informed Decisions about Breast Reconstruction: A Webinar

Pictured: Andrea Pusic

Plastic and reconstructive surgeon Andrea Pusic

Women diagnosed with breast cancer face many difficult decisions about their care, including ones that may affect their quality of life after treatment. If mastectomy is part of their treatment plan, a majority of women consider breast reconstruction as a way to restore anatomy and symmetry, either with artificial implants or by using their own tissue. Some who choose lumpectomy may also think about improving their cosmetic result with breast reconstruction.

According to Memorial Sloan Kettering plastic and reconstructive surgeon Andrea Pusic, “breast reconstruction can help mitigate the psychological, social, sexual, and physical impact of treatment, improve concerns about body image, and enhance a woman’s long-term quality of life.”

However, there are a number of state-of-the-art techniques as well as personal preferences to consider when making the decision to have breast reconstruction. Additionally, timing and coordination with cancer treatment is crucial.

“It is vital to be fully informed about the pros and cons of the different methods and have realistic expectations about what reconstruction can achieve for you,” Dr. Pusic says. “Knowing what to expect goes a long way in decreasing anxiety and making you feel comfortable with your choices.”

Managing Expectations

To that end, Dr. Pusic developed a research tool called the BREAST-Q© to measure patient satisfaction with surgical outcomes and quality of life after breast reconstruction. Now used in clinical practice throughout the United States and internationally, the questionnaire is designed to capture patients’ perspectives on the most important aspects of their experience before and after the reconstruction process.

Thousands of women continue to provide long-term feedback for the BREAST-Q years into their survivorship. “Most women considering breast reconstruction want to know what others in their situation have said works and doesn’t work, and the BREAST-Q has been invaluable in helping patients get a better understanding and appreciation for what to expect,” says Dr. Pusic.

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Webinar with Dr. Pusic

Learn more about breast reconstruction in this recording of a live webinar that was hosted by the online cancer community CancerConnect on Wednesday, July 16, 2014. Dr. Pusic provides an overview of breast reconstruction options, the factors involved in determining the ideal surgical approach, and how patient satisfaction with outcomes is being improved.

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I have had multiple attempts for reconstruction...latest
was the dorsi flap but didn't seem to right side expander
is out of place....beginning to give up...: (

Hi, Nancy, we are sorry to hear about your poor experience with breast reconstruction thus far. Hopefully you have brought these issues to your surgeon’s attention and they are being addressed. If you are not already an MSK patient and would like to meet with one of our plastic surgeons, please call our Physician Referral Service at 800-525-2225.

Thanks for your comment.

What are the pros and cons to having implants prior to radiation treatments?

Dear Maryellen, we sent your inquiry to Dr. Pusic and she responded:

“By having the implants placed before radiation, we avoid the increased risk of infection and wound-healing problems that may occur in patients having implants placed after they have received radiation.”

If you have additional questions and would like to make an appointment to consult with one of our plastic surgeons, please call our Physician Referral Service at 800-525-2225.

Thank you for your comment.

It's incredible to see the continual advances in medicine and technology, often interlinked.

I am a breast cancer survivor, having a total mastectomy, chemo and radiation.
My chest wall is thin, I have been told that reconstruction has a 25% chance of failure because of my thin chest and abdomen. No tummy fat to move around. My concern is that the other microvascular surgery would involve skin from my shoulder area.. Do I consider another scar? I do swim for exercise and need range of motion. I did have a problem with a long time to drain all the lymphatic fluid. After the drain was pulled, I needed twice more needle drainage. My other breast is about a 34a… small… Is there a way to consider reconstruction? Are implants out of the question with prior radiation?
thank you for your time.

Dear Kami, unfortunately, we cannot answer these kinds of personal medical questions on our blog. If you would like to make an appointment for a consultation with one of our plastic surgeons to discuss these issues in more detail, please call our Physician Referral at 800-525-2225.

You may also be interested in tuning in to view the live webinar mentioned in our blog post tomorrow (July 16, 2014 at 6:30 pm EST) on The live web chat featuring Dr. Pusic may offer some additional helpful information.

Thank you for your comment.

Hello ,
I was just diagnosed with breast cancer and will be having a double mastectomy with reconstruction . My plastic surgeon said I'm one of those people that falls into the " grey area" I have some belly fat and as long as I want to go smaller I'm a candidate for the flap surgery or implants . Other than the surgery taking longer ... Can you tell me pros and cons ? Also if you feel one is more risky than the other .