In 2021, the World Health Organization’s International Agency for Research on Cancer (IARC) released the latest global cancer data. Data show that the number of new breast cancer cases reached 2.26 million, accounting for about 11.7% of new cancer cases. This is also the first time that the number of new breast cancers has surpassed lung cancer, becoming the “world’s largest cancer”. Surgery is one of the main forms of treatment for breast cancer patients. However, many patients worry that the breast will be removed together, which will affect the external appearance and reject the surgery. In fact, with the advancement of medicine, the surgical treatment of breast cancer patients does not necessarily require the removal of the breast. Even if the breast is removed, breast reconstruction can be performed, so that women no longer miss treatment because they are worried about being “unbeautiful”.
Do you have to cut milk to save your life? That’s not necessarily
After more than 40 years of breast-conserving practice in breast cancer at home and abroad, it is generally accepted in the industry that breast-conserving surgery for breast cancer will not reduce the prognosis of patients. Therefore, for suitable breast cancer patients, breast-conserving surgery is completely feasible, and the breast-conserving surgery is less traumatic and less painful for patients. While preserving the integrity of the breast shape, it also takes into account the postoperative functional recovery.
No breast preservation, also rebuildable
If breast conservation is not possible, will the patient lose the breast forever? With the development of modern material science and plastic and cosmetic medicine, breast reconstruction has been greatly developed. In general, breast reconstruction is performed for most breast cancer patients whose breasts have been removed. Breast reconstruction includes autologous tissue reconstruction and prosthetic reconstruction. Autologous tissue reconstruction refers to the transfer of tissues in the abdomen, buttocks, back and other parts to the chest, followed by vascular anastomosis and shaping to achieve the purpose of making breasts. This method uses its own tissue, which is more realistic in appearance, but because it requires a sufficient amount of tissue in the donor area, it is more suitable for middle-aged and elderly patients, who have given birth, and have a plump body.
Prosthetic reconstruction refers to the use of artificial materials to fill out a breast shape, that is, using silicone implants or expanders to replace the removed breast glands and reshape the shape of the breast. The method is small in trauma, simple in operation and short in operation time. This method requires a certain cavity to place a breast prosthesis and requires a certain thickness of soft tissue in the patient’s chest, which is not suitable for extremely thin patients. At present, the most widely used and easily accepted surgical method is prosthetic reconstruction.
According to the timing of reconstruction, breast reconstruction can be divided into immediate reconstruction, delayed reconstruction and staged immediate breast reconstruction. Immediate reconstruction means that breast reconstruction can be performed at the same time as total mastectomy. The advantage is that the important anatomical structure of the breast can be preserved, the operation cost can be saved, the patient will not experience the pain of losing the breast, and it is helpful for postoperative psychological adjustment. Breast reconstruction can also be done months or years after a mastectomy, called delayed reconstruction. If it is not possible to determine whether postoperative radiotherapy is required before mastectomy, a dilator can be implanted first. According to the postoperative pathological changes, the permanent breast prosthesis or autologous tissue breast reconstruction can be selected. This is staged immediate breast reconstruction.
Precautions after breast reconstruction
Rehabilitation and care of patients after breast reconstruction is also very important. Correct rehabilitation exercises, dietary habits and daily care can help patients recover quickly.
1. Limit strenuous activities of the upper limbs in the short term after surgery to avoid displacement of the prosthesis.
2. 1-2 days after the operation, the wrist and elbow joint on the affected side can be moved, such as making a fist, extending the fingers, and flexing the elbow. The affected limb should not sag for a long time, and the shoulder joint is naturally adducted and braked in the short term after the operation.
3. Two days after the operation, the forearm exercise should be added on the basis of the above, and more practice should be done to touch the contralateral shoulder and the ipsilateral ear with the affected hand.
4. After the patient’s wound is healed, the drainage tube is removed and there is no subcutaneous fluid, the shoulder joint movement can be performed step by step. It should be noted that shoulder joint functional exercises should be carried out under the guidance of doctors in combination with their own conditions such as drainage volume, wound healing, and subcutaneous effusion.
5. Compression bras and compression bandages should be worn for 4 weeks after surgery.
1. It is advisable to consume high-protein, high-vitamin and easily digestible foods.
2. Use health products and hormone foods with caution.
3. Limit the intake of coffee, high-fat foods, and quit smoking and alcohol.
1. It is forbidden to measure blood pressure, injection, infusion, etc. on the upper extremity of the affected side. At the same time, pay attention to keeping warm and insist on functional exercise to the functional level of the healthy side.
2. Patients with prosthetic breast reconstruction should avoid weight-bearing on the affected arm and injury of the prosthesis, avoid squeezing the breast forcefully, and recommend “supine” sleeping position, and try to avoid lying on the side in the same direction for a long time and increase the burden on the prosthesis.
3. For patients undergoing breast reconstruction with rectus abdominis, the abdominal incision should be bandaged with abdominal belt compression to avoid abdominal collision as much as possible. When coughing or sneezing, you must press your abdomen with both hands. At the same time, patients should maintain smooth bowel movements to avoid increasing intra-abdominal pressure and causing complications such as incisional hernia.
4. Pay attention to the situation of the incision. If there are symptoms and signs such as local redness, incision dehiscence, elevated skin temperature, and elevated body temperature, seek medical attention in time if infection is suspected.
5. When the patient’s wound is healed, the drainage tube is removed and there is no subcutaneous effusion, breast massage can be learned to prevent prosthesis capsular contracture.
6. Regularly go to the hospital for re-examination, once every 3 months within 2 years after surgery, once every six months from 2 to 5 years, and once every year for more than 5 years.
7. Regular work and rest, appropriate participation in outdoor activities, and maintain a happy mood.