Breast cancer patients can now undergo breast amputation and nipple-retaining breast reconstruction in one procedure.
Sophie Williams, 42, a marketing South West London consultant, had done it, as she says CAROL DAVIS.
Sophie Williams, 42, a marketing consultant from South West London, had the all-in-one operation
When I was in bed on a February morning this year, my left breast felt uncomfortable – I looked and felt a lump.
Although I usually check my breasts regularly, I was busy and hadn't done this for a few months.
I saw my doctor a few days later and she referred me to a mammogram that I had a week later. On research, the consultant said it was probably a tumor – I was scared, but determined to fight it.
The following week, after an ultrasound and a biopsy, I was told that I had a 3.5 cm tumor on my left. I was prepared for this the week before, so I think my husband (Goran, 42, editor of a magazine) was more shocked than me.
I didn't want delays, so I used my private health insurance policy through work to be transferred to a private hospital, where I had more detailed blood tests and scans, as well as a BRCA test, which checks for genetic causes – there were none.
The doctors said it was a triple negative breast cancer, meaning it would not respond to hormone drugs, and I would need a breast amputation.
I wanted to avoid the limitations of wearing a prosthesis after my breast was removed – I am young and the gym is a big part of my life, and I thought it would get in the way – so I saw a plastic surgeon to talk though reconstruction options.
An implant would mean surgery every ten years to replace it, or I could have a reconstruction with my own body tissue – but this would mean two surgeries to remove the tumor and breast tissue and then remove the breast six months later reconstruct as soon as I was fully recovered. Both options also concerned the loss of my nipple.
I told the surgeon that I wanted to prevent having more than one operation if I could.
She explained that they could do a two-in-one operation in which a breast cancer surgeon would remove the tumor and then, the plastic surgeon, would reconstruct the breast using tissue from my abdomen.
All this would be done by an incision less than 10 cm below my chest – it would leave a hidden scar and retain my nipple.
Breast cancer patients can now undergo breast amputation and nipple-retaining breast reconstruction in one procedure. Pictured: Sophie Williams who had the operation
So instead of tilting and hiding a prosthesis, or worrying about repeat surgery, I would have formed a breast from my own tissue, which would have been carefully adjusted to my right breast and would arrive or lose weight if I did . It sounded great.
First I had 16 rounds of chemotherapy for six months to reduce the tumor – I felt tired and lost my hair but was good enough to work. The tumor had shrunk to 1.5 cm in August and I was operated on six weeks later.
After the eight-hour operation, I had morphine for 24 hours and then switched to paracetamol and ibuprofen. I stayed in the hospital for a week as they checked the blood flow to my new breast tissue.
Afterwards laboratory tests showed that the cancer had disappeared and I will receive mammograms regularly to ensure that this remains the case. After I got home, Goran first took me on gentle walks; I was good enough to ride and returned to work after six weeks.
We plan to draw a line under 2019 and all my treatment with a wonderful Christmas, then a beach holiday in Thailand and Malaysia in January, where I can wear a bikini with confidence.
Victoria Rose is a plastic and reconstructive surgeon advisor at the NHS Foundation Trust and DRG Plastic Surgery Clinic of Guy & St 39, both in London.
About one in eight women gets breast cancer and about one third requires breast amputation, total removal of the breast. Approximately 30 percent of women with a breast amputation have a reconstruction.
Mastectomy traditionally meant removing the nipple and breast tissue through a scar right across the breast – and although a nipple can be tattooed later, it is difficult for many patients to handle it.
WHAT ARE THE RISKS & # 39; S?
- There is a risk of 5 percent for infection and a risk of less than 10 percent for fluid retention in the abdomen.
- There is a 5 percent risk that blood flow to the tissue will fail, leading to a second operation.
& # 39; If tissue is taken from elsewhere in the body, there are two surgical locations and the use of an abdominal location can cause weakness & # 39 ;, says Grainne Bourke, consultant plastic surgeon at Leeds Teaching Hospitals NHS Trust and Spire Leeds Hospital .
& # 39; but this is an excellent technique using the patient's own tissue and is generally successful without the risk of using foreign material. & # 39;
We can reconstruct a breast with the help of an implant, but this can mean more operations later when the other breast changes and leaves the body asymmetrically.
There is also a very rare risk of breast cancer associated with certain types of implants – about one in 33,000.
We also offer a deep inferior epigastric perforator (DIEP) flap, where we take tissue from the abdomen to create a breast that changes as a patient ages or arrives and gives good symmetry.
Both procedures included having the nipple removed and a second operation, because it was thought that leaving the nipple increases the risk of breast cancer returning.
However, studies have now shown that carefully holding the nipple in carefully selected patients is not risky – we send nipple tissue to the laboratory during surgery to be examined for any breast cancer cells and call patients back to the theater if found.
As a result, the National Institute for Health and Care Excellence has approved nipple-saving breast amputation for suitable patients, and at the same time we can offer a nipple-saving, skin-retaining reconstruction through an incision in the fold under the breast where it is naturally hidden, using the DIEP -flap of the abdomen, which reduces the time under anesthesia and recovery.
This is very exciting and is suitable in cases where the original tumor is at least 3 cm from the nipple.
Only a few surgeons do this because it is technically more difficult to work through a smaller incision, although we are publishing an article to show that we have had no problems damaging the breast skin, damaging the nipple or not complete removal of the tumor – and that psychologically it is much better for patients to retain their nipples and to undergo surgery once.
The operation takes six to eight hours under general anesthesia. The surgeon makes an incision of 10 cm below the breast to perform the breast amputation and removes the sentinel gland, the first one that a cancer would travel to, to test if the cancer has not spread.
I then make an incision from hip to hip, hidden in the bikini line.
I identify the blood vessel that feeds this tissue area and take an oval-shaped patch of skin and fat – the size varies depending on the size of the patient – with the blood vessels that feed it, from the abdomen and move it up to the breast area, where his blood vessels are connected to blood vessels that have supplied the breast.
I work through the small incision made by the breast cancer surgeon, shaping the repositioned tissue in the breast to create good symmetry and attach it in place with soluble sutures.
I place a probe at the connection so that I can continue to check if the blood supply is healthy – the probe will be removed after a few days as soon as we are convinced that the new blood supply has established itself.
This procedure gives very good aesthetic results, so that patients do not undergo further surgery.
- The operation costs around £ 24,000 at the NHS or privately.
Are advent calendars a gift for your health?
Nothing beats the Christmas atmosphere of an advent calendar and with these options you can treat yourself without going overboard. . .
NOMO: The chocolate here is free of dairy products
£ 9.99, hollandandbarrett.com
Good for people with allergies, the chocolate is free of dairy, gluten, eggs and nuts.
£ 9.99, amazon.co.uk
This produces 24 different flavors of tea. Warming up wild apple and cinnamon is a particularly festive mix, while the antioxidants in green tea can combat excessive pleasure.
100% DARK CHOCOLATE
£ 12.50, hotelchocolat.com
For those who prefer to give their chocolate a shot. The chocolate here is vegan and made with Ecuadorian cocoa from one origin, which is full of intense taste. There is also a similar vegetarian version.
£ 17.50, popcornshed.com
For a sweet treat that is marginally more virtuous than chocolate, this calendar offers a bag of popcorn every day. Flavors include cheese and raspberries with dark chocolate.
PROTEIN BALL: There is a protein ball behind every window of this calendar
£ 19.99, theproteinballco.com
There is a protein ball behind every window of this calendar, with flavors including peanut butter. They each contain 5 g to 10 g of protein, contain no added sugars and are free from soy, wheat and gluten.
£ 34.95, souschef.co.uk
Do you like licorice? This is for you, because each window hides two licorice pieces with a different taste. The liquorice – made from gluten-free rice flour – offers iron that can increase energy levels.
£ 20, beaniesflavourco.co.uk
There is much to love about the health benefits of coffee: each cup contains many antioxidants that help protect our cells from damage. Here you get two bags of flavored coffee every day – and each is only two calories per cup.
PLAMIL WHITE CHOCOLATE: it contains an alternative to dairy-free white chocolate
BOOSTBOX VEGAN PROTEIN
£ 39.99, getboostbox.co.uk
Filled with 25 full-size, vegetable snacks, from bars to nut pasta and cookies – all rich in protein. It contains products from popular brands such as Bounce and Pulsin.
PLAMIL WHITE CHOCOLATE
£ 4.95, plamilfoods.co.uk
This contains a dairy-free alternative to white chocolate made in a factory that never uses dairy or gluten. The treats are made from a mix of cocoa butter, sugar and rice.
. (TagsToTranslate) Dailymail (t) health (t) London