Every October, through press and programing, the public’s attention is brought again to the fight that some of our citizens endure year-round. As we consider the treatment process that patients with breast cancer complete, it is helpful to consider what a successful treatment course looks like for some of these survivors.
The American Cancer Society estimates that nearly 3.8 million US women were living with a history of breast cancer as of January 2019. This includes patients who no longer have evidence of cancer, whereas others who may still be continuing through their treatment course for the disease. Approximately 13%, or 1 in 8 American women will be diagnosed with an invasive breast cancer in their lifetime. Between 2012-2016, the average age for breast cancer diagnosis was 62 years, meaning that approximately half the women in this country who developed breast cancer were younger than that age at the time of their diagnosis. At the same time, overall breast cancer death rates have decreased rapidly, with a total decline of 40% through 2017, attributable to improvements in treatment and earlier detection.
While breast cancer remains one of the leading causes of cancer diagnosis and death in American women, the majority of patients will complete their treatment course and survive many years after diagnosis. Over 90% of patients live 5 years or more after their diagnosis, with nearly 85% alive after 10 years and 80% after 15 years. For a disease localized to the breast, surgery is still the mainstay of treatment, whether this is lumpectomy, also known as a partial mastectomy, or removal of the entire breast, also known as a mastectomy. However, any surgical procedure resulted in scarring, and any surgical procedure removing tissue can often leave contour deformities, irregular shape, and asymmetries.
Many women who are cancer survivors have the sequelae of their surgical treatment to remind them of their fight against cancer. Often, these unfavorable scars or contour deformities are bothersome reminders of their life-altering diagnosis. Life-saving treatments such as radiation, which enable many women to live long, productive lives, can also make reconstruction more difficult and cause problematic scarring of the breast tissues. Thus, many survivors of breast cancer deal with a daily reminder or unwelcome deformity resulting from their cancer removal.
Fat grafting for correcting breast contour deformities after breast cancer is becoming increasingly important to help correct these deformities after breast surgery. In the 1990’s Sydney Coleman, a plastic surgeon in New York City, described techniques for fat harvesting with liposuction, processing this fat, and reinjecting it to fill and correct contour deformities. This process has grown wildly in the US in the years since, with many Americans being familiar with this practice for lip filling procedures or for gluteal augmentations (aka Brazilian butt lifts) in their favorite celebrities. Fat is a safe and long-lasting filler, is safe in the radiated or previously reconstructed breast, and has few downsides. One of these is that these patients do still require breast imaging (mammograms, ultrasounds), and if abnormalities are seen after fat grafting, they may still require additional biopsies or studies.
Fat transfer procedures aren’t just for celebrities these days. Breast cancer patients can benefit from these relatively minimally invasive procedures to even out asymmetries or fill dents in the breast. Most insurance companies cover these procedures when used to reconstruct the breast. This is one of the most sought-after procedures in our practice at Women & Infants and Kent Hospital’s since patients obtain liposuction of what they identify as their “problem areas” and correct the breast. These procedures are performed under general anesthesia or sedation and typically take less than 1 hour. Patients are discharged comfortably the same day, without troublesome drains or breast incisions, and can shower the next morning. A common question is whether there is a “statute of limitations” on these procedures or if they can be applied to defects from years ago. These procedures work as well for defects from years ago as they do more recent deformities and can even help with breast asymmetry by making the smaller breast larger by a cup size or more.
As we celebrate our mothers, sisters, and friends in their journey and breast cancer survivorship this October, our practice is excited and proud to offer them improvements over their previous reconstructive results. This safe and effective, minimally invasive procedure can help restore quality of life and breast/body self-image in our breast cancer survivors to allow them to proudly enjoy their cancer-free results.