by Dr Shraddha Deshpande, Cosmetic Surgeon, Wockhardt Hospital Mumbai Central
Breast Cancer is the most common malignancy occurringin Indian woman. The rate being as high as 25.8 per 1,00,000 women. The incidence of Breast cancer is rising and what is alarming is the age group in which it is being diagnosed. More and more younger women are being affected by Breast Cancer. Breast Cancer has been seen to occur a nearly a decade earlier in Indian Women as compared to the western population. Studies suggest that the disease burden peaks in the age group of 40-50 years in Indian women. Due to increased awareness and improved diagnostic tools the number of women undergoing treatment for breast cancer has increased significantly. However, out of the number of women undergoing mastectomy in India, a shockingly low percentage of women undergo breast reconstruction. The reasons can be variable.
1. Lack of awareness regarding breast reconstruction.What is breast reconstruction?
The goal of breast reconstruction is to restore one or both breasts to near normal shape, appearance, symmetry and size following mastectomy, lumpectomy or congenital deformities.
Breast reconstruction often involves multiple procedures performed in stages and can either begin at the time of mastectomy or be delayed until a later date. Breast reconstruction generally falls into two categories: implant-based reconstruction or flap reconstruction. Implant reconstruction relies on breast implants to help form a new breast mound. Flap (or autologous) reconstruction uses the patient’s own tissue from another part of the body to form a new breast. The type of reconstruction depends on a number of factors like the type of mastectomy, adjuvant treatment plans, the type of cancer as well as the patient’s body type. A lot of women are not aware of these options when they undergo surgery, or have a lot fear and apprehension about it. Such procedures are routinely done in western countries where they are a norm rather than an exception. Every breast cancer patient consults a Plastic and reconstructive surgeon beforehand to know her options and the pros and cons of each procedure.
Lack of Foresight.
Many women are in a state of denial and panic when they are diagnosed with Breast cancer. Once they complete their treatment, they regret not opting for a breast reconstruction at the mastectomy stage. Even though a delayed reconstruction can be performed, an immediate reconstruction gives much better cosmesis due to availability of skin envelope, also allows the patient to wake up with a reconstructed breast and saves repeated anaesthesia exposure.
Cancer is a debilitating disease. The investigations and treatment modalities involved in Cancer care including Surgery, Chemotherapy and Radiotherapy are expensive. With limited resources, some women do not undergo reconstruction due to financial constraints. However, the good news is that Health Insurance Companies have included the entire spectrum of cancer care in their policies now and reconstructive surgeries also are being covered. Most corporate or group insurances cover immediate as well as delayed breast reconstruction.
The last two decades have seen tremendous advancement in cancer care and the mortality rates due to breast cancer have significantly reduced. With the new and advanced techniques of Breast reconstruction women can not only be disease-free but also live a socially active and fulfilling life.
The new age Cancer management involves a holistic approach to cancer care, not just increasing the longevity but also the quality of life of Women.