Partial Mastectomy an Option for Some Patients
By Ronni Gordon
Beth Israel Deaconess Medical Center correspondent
After a mammogram in 2009 revealed that Marybeth Chung had a tumor in her right breast, she was relieved to learn that it was benign — but worried that surgery would leave her looking different on each side.
"I thought it would leave me somewhat disfigured, and that did make me anxious," said the 40-year-old lawyer, who lives in Dover with her husband and their two children, ages 4 and 6.
Chung had a type of breast disease called fibroadinoma, with a painful lump that grew to more than 4 centimeters.
Chung's surgeon at the BreastCare Center at Beth Israel Deaconess Medical Center, Dr. Ranjna Sharma, shared her concern about the aesthetic outcome and suggested Chung consult with a plastic surgeon.
That's where Dr. Samuel J. Lin, a plastic surgeon at BIDMC, made a difference.
After Sharma finished the operation — removing some of the tissue around the lump — Lin stepped in and reconstructed the breast using Chung's own tissue.
"I'm so glad they gave me this option," Chung said. "The outcome was amazing. My breast looks the same as it did before the surgery. Because of the reconstruction, I have been able to put my experience with breast disease completely behind me. I don't think about it at all."
While it is probably harder for women who have had cancer to put the experience behind them, reconstruction after partial mastectomy stands a good chance of improving their outlook.
"This is about making them whole again," Lin said. And, he wants more women to know about the options that he believes fill a need.
"Patients don't realize this is available," he said. "It's been more popular in Europe for one reason or another, but it is something that people need to hear about in this country."
According to Lin, the term "partial mastectomy" applies to a continuum of surgeries, starting with a lumpectomy.
In a lumpectomy, the surgeon removes only the breast lump and some normal tissue around it. Radiation treatment is usually given after this type of surgery. If there is cancer at the edge (called the margin) of the piece of tissue that was removed, the surgeon may need to go back and take out more tissue.
With a partial mastectomy, the surgeon removes more of the breast tissue than in a lumpectomy (up to one-quarter of the breast). It is usually followed by radiation therapy.
Lin said reconstruction after this kind of surgery is being done at scattered centers, including BIDMC, and more are joining those ranks.
"This technique has been termed 'oncoplastic reconstruction,'" he noted. "It's the concept of using available local tissue — fat and skin — to reconstruct breast defects."
According to Lin, the technique employs an array of procedures, most often removing fat and skin from the breast, the armpit area and the latissimus muscle — the largest muscle in the back.
He called the decision on whether to have reconstruction "a very individual process."
"It may or may not depend on size," he said. "It's more about the person."
"I see patients who have had a relatively small amount removed, but it consumes them and they think about it every day and they really want to treat it," Lin added. "Much of what we do as plastic and reconstructive surgeons is about improving a patient's quality of life. It is very rewarding."
Make an Appointment at the BreastCare Center
Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.
Posted March 2012