Patient issues in breast reconstruction

Article Abstract:

Women with breast cancer are faced with more decisions than ever before. There are more options in treatment, and more options in breast reconstruction as well. Many women chose breast reconstruction, often as the result of practical considerations about clothing and bathing suits. Other women decline the option, sometimes stressing a reluctance to undergo further surgery. Some women view breast reconstruction as an important way to regain a sense of femininity, others regard it as unnecessary and indicate that they do not believe the loss of a breast will alter the quality of their lives. At present, surveys indicate that roughly three-quarters of breast cancer patients who underwent breast reconstruction were quite satisfied with the result. The American Cancer Society publishes a booklet entitled "Breast Reconstruction: A Matter of Choice." The booklet provides answers for women, but the questions themselves should be considered by medical practitioners. Every question asked reflects concerns not only about health and appearance, but also reflects social, psychological, and financial concerns as well. The questions asked about breast reconstruction may indicate underlying anxiety. Questions regarding pain clearly indicate anxiety about the procedure itself, but a less perceptive physician might not recognize that concerns regarding length of recovery period may actually indicate financial concerns, child care concerns, or worries about simply getting on with one's life. In breast cancer, as in many diseases, providing the best care for the patient means understanding more than the mechanics of treatment, it requires an understanding of how the disease actually affects the patient. (Consumer Summary produced by Reliance Medical Information, Inc.)

Psychological aspects, Surgery, Surgery, Plastic, Plastic surgery, Mammaplasty, Breast reconstruction, Breast surgery

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Fine-needle aspiration biopsy and cytologic findings of surgical scar lesions in women with breast cancer

Article Abstract:

Breast cancer is the most common cancer affecting women in the western world. Recurrence of breast cancer may be anticipated in 10 to 40 percent of women undergoing mastectomy; the more advanced the cancer at the time of surgery the more likely is recurrence. The likelihood of recurrence demands that any lesion developing in the surgical scar be evaluated. However, obtaining a biopsy of the surgical scar lesion may be a problem, as many women prove reluctant to undergo yet another surgical intervention. Fine-needle aspiration biopsy may prove useful in such cases. The aspiration of breast cells through a slender needle is rapid, safe, and well tolerated by patients. A study was conducted to evaluate the effectiveness of fine-needle aspiration biopsy in the examination of 83 breast scar lesions. The biopsy method was able to identify cancer cells in 38 specimens. In 20 specimens, sufficient normal cells were present to rule out malignancy. In the remaining 25 specimens, the aspirated material contained no cells or too few cells for diagnosis. It should be mentioned, however, that while 23 of 51 specimens drawn by inexperienced doctors were unsatisfactory for diagnosis, only two of the 32 specimens drawn by cytopathologists experienced in performing fine-needle biopsy were unsatisfactory. These results suggest that fine-needle aspiration biopsy might well be routinely used in the evaluation of surgical scar lesions in breast cancer patients. The biopsy must, however, be performed by an appropriately trained and experienced practitioner. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Biopsy, Needle, Needle biopsy, Breast biopsy

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