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Published on October 08, 2013

Oct. 16: Day Raises Awareness for Breast Reconstruction

COLUMBIA, Mo. - As part of National Breast Reconstruction Awareness (BRA) Day on Oct. 16, experts with Ellis Fischel Cancer Center are educating the public about the advanced breast reconstruction options available to women who have undergone a mastectomy.

"There are many patients out there who have had a breast cancer diagnosis and need surgery for it but don't really know what their reconstructive options are," said Stephen Colbert, M.D., plastic and reconstructive surgeon at Ellis Fischel Cancer Center and assistant professor of surgery in the MU School of Medicine's Division of Plastic and Reconstructive Surgery. "At Ellis Fischel, we provide a comprehensive approach to breast cancer care, and we offer a range of personalized reconstruction options to patients."

According to the American Cancer Society, one in eight women will develop breast cancer in her lifetime. Based on individual risk factors and discussions with their physicians, some women choose to undergo surgery to remove part of the breast tissue or the entire breast. Patients may choose to have reconstructive surgery to rebuild the breast to match its original shape and look.

There are two primary reconstruction methods: implant-based reconstruction or using a patient's own tissue to reconstruct the breast.

"Implant-based reconstruction is the most common procedure, but we have many patients who choose to have tissue-flap procedures, which use the tissue from their bellies, backs, thighs or buttocks to rebuild the breast," Colbert said. "These procedures can result in a reconstructed breast with a more natural look and feel."

The most common types of tissue-flap procedures are the transverse rectus abdominis muscle (TRAM) flap, which uses tissue from the lower belly area, and the latissimus dorsi flap, which uses tissue from the upper back.

In a TRAM flap procedure, the surgeon can leave the flap attached to its original blood supply and tunnel it under the skin to the breast, forming a pocket for an implant or creating the breast mound itself. This is referred to as a pedicle flap procedure. Or, the surgeon can cut the flap of skin, fat, blood vessels and muscles for the transplant away from its original location and then attach it to the blood vessels in the chest using a microsurgical procedure. This is referred to as a free-flap procedure.

Ellis Fischel Cancer Center is the only health care provider in mid-Missouri to offer the deep inferior epigastric artery perforator (DIEP) flap method. A DIEP flap procedure uses fat and skin from the same area as a TRAM flap but does not use the muscle to form the breast mound. The tissue is attached to the blood vessels in the chest using a microsurgical procedure. Because the procedure uses skin and fat from the lower belly, the cosmetic result is similar to a tummy tuck.

"By discussing their reconstruction options with a plastic surgeon, women can choose the procedure that is the best fit for them," Colbert said. "We work closely with a team of surgical oncologists to provide either immediate reconstruction following a tissue removal procedure or a delayed reconstruction process, depending on a patient's needs."

To learn more about Ellis Fischel Cancer Center's breast reconstruction options, call the Division of Plastic and Reconstructive Surgery at (573) 882-2275.