Looking in the mirror after breast cancer surgery


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Thomas Froehlich, M.D., M.S., the Medical Director of all cancer clinics at UT Southwestern’s Harold C. Simmons Cancer Center, says he has seen cancer care improve dramatically over the last few decades.

One thing I talk about with breast cancer patients is what treatment will do to their appearance.

Though stopping cancer is the foremost goal with any patient, some women worry about what they’ll look like in the mirror after surgery. We listen to and understand the importance of those feelings. We also know that part of our job is to make women aware of their options and to let them know about the great advances in breast cancer treatment.

For most of the past century, radical mastectomies were thought to be the safest way to stop breast cancer. In that procedure, surgeons removed breast tissue and the underlying muscle and lymph nodes. The surgery saved lives, but it was “radical,” leaving women with scarred, uneven chests.

Today, though, we can perform a lumpectomy in many cases, removing only the cancerous breast tissue and leaving behind the healthy tissue. Radiation treatment then follows surgery to halt the growth of cancer. We also can offer patients breast reconstruction, which, in many cases, leaves the breast looking almost as it did before surgery. Keep in mind, though, that breast surgery usually leaves the breast with little or no sensation.

In some cases, we must perform a mastectomy and remove more breast tissue. Modern mastectomies, however, spare the muscle, skin, and sometimes even the nipple. The plastic surgery team can replace breast tissue with a silicone implant. The team also can reconstruct a nipple and areola using tissue from other parts of the body. Some patients opt for a tattooed nipple and areola; 3-D tattooing offers excellent results.

Nipple-sparing surgery

We are excited to offer nipple-sparing breast cancer surgery to our patients at UT Southwestern. In this procedure, we extract the affected breast tissue through incisions – hidden beneath the breast – that spare the patient’s nipple and areola. The incisions are rarely seen, even in swimwear.

While this option is ideal, it is not for all patients. The surgery is usually reserved for younger patients, particularly those undergoing double mastectomies for cancer prevention. Preventative mastectomies are performed on women who have a genetic predisposition to developing breast cancer.

Inform yourself

If you have had a breast cancer diagnosis, make sure you do as much research as you can about your exact condition. Ask your doctor all your questions, and share your feelings and fears. We want to help you choose the best option for your particular condition.